Diagnosis of Intercritical Gout
Authors: Eliseo Pascual, Enrique Batlle-Gualda, Agustín Martínez
Journal: Annals of Internal Medicine (2000)

Letters16 May 2000Diagnosis of Intercritical GoutEliseo Pascual, MD, PhD, Enrique Batlle-Gualda, MD, PhD, and Agustín Martínez, MDEliseo Pascual, MD, PhDHospital General Universitario de Alicante; Alicante, Spain 03010 (Pascual)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Batlle-Gualda)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Martínez)Search for more papers by this author, Enrique Batlle-Gualda, MD, PhDHospital General Universitario de Alicante; Alicante, Spain 03010 (Pascual)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Batlle-Gualda)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Martínez)Search for more papers by this author, and Agustín Martínez, MDHospital General Universitario de Alicante; Alicante, Spain 03010 (Pascual)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Batlle-Gualda)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Martínez)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-10-200005160-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Johnson's point is accurate and pertinent. Our data indicate that after monosodium urate crystals form, they stay indefinitely in the joint (and for diagnostic purposes can be found in synovial fluid samples) as long as hyperuricemia persists. Furthermore, during intercritical periods, in these gouty joints there is an intense interaction between crystals and cells, as shown by the regular finding of cells with phagocyted monosodium urate crystals in synovial fluid samples drawn from these joints (1). The higher than normal leukocyte counts in these same synovial fluid samples (2), which decrease after low-dose colchicine prophylaxis (3), indicate ...References1. Pascual E, Jovaní V. A quantitative study of the phagocytosis of urate crystals in the synovial fluid of asymptomatic joints of patients with gout. Br J Rheumatol. 1995;34:724-6. CrossrefMedlineGoogle Scholar2. Pascual E. Persistence of monosodium urate crystals, and low grade inflammation, in the synovial fluid of untreated gout. Arthritis Rheum. 1991;34:141-5. CrossrefMedlineGoogle Scholar3. Pascual E, Castellano JA. Treatment with colchicine decreases the white cell counts in the synovial fluid of asymptomatic knees which contain monosodium urate crystals. J Rheumatol. 1992;19:600-3. MedlineGoogle Scholar4. Baker DG, Schumacher HR. Acute monoarthritis. N Engl J Med. 1993;329:1013-20. CrossrefMedlineGoogle Scholar5. Schapira D, Stahl S, Izhak OB, Balbir-Gurman A, Nahir AM. Chronic tophaceous gout mimicking rheumatoid arthritis. Semin Arthritis Rheum. 1999;29:56-63. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Hospital General Universitario de Alicante; Alicante, Spain 03010 (Pascual)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Batlle-Gualda)Hospital General Universitario de Alicante; Alicante, Spain 03010 (Martínez) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSynovial Fluid Analysis for Diagnosis of Intercritical Gout Eliseo Pascual , Enrique Batlle-Gualda , Agustín Martínez , José Rosas , and Paloma Vela Diagnosis of Intercritical Gout James R. Johnson Metrics 16 May 2000Volume 132, Issue 10Page: 843KeywordsArthritisCellsColchicineGoutInfectious diseasesInflammationProphylaxisRheumatoid arthritisSynovial fluidUric acid Issue Published: 16 May 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...