Gout: an old friend in the framework of current recommendations

Abstract

Gout is a systemic disease that results from the deposition of monosodium urate crystals (MSU) in tissues as a result of uric acid metabolic disorders. It is the most well understood and described type of arthritis. New insights into the pathophysiology of hyperuricemia and gouty arthritis provide new opportunities in the development of diagnostic and therapeutic strategies. The role of genetic predisposition is becoming more evident. The clinical picture of gout is divided into asymptomatic hyperuricemia, acute gouty arthritis, intercritical period, and chronic tophaceous gout. Diagnosis is based on laboratory and radiological features. The gold standard of diagnosis is identification of characteristic MSU crystals in the synovial fluid using polarized light microscopy. Imaging
modalities include conventional radiography, ultrasonography, computered tomography, magnetic resonance imaging, nuclear scintigraphy, and positron emission tomography. Management of gout includes management of flares, chronic gout and prevention of flares, as well as management of comorbidities. Newer drugs in the pharmacological armamentarium are proving successful andsupplement older ones. Other important points in its management include patient education, diet and life style changes, as well as cessation of hyperuricemic drugs.