Gout - Knowledge (XXG)

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sleeps in good health. About two o'clock in the morning he is awakened by a severe pain in the great toe; more rarely in the heel, ankle, or instep. The pain is like that of a dislocation and yet parts feel as if cold water were poured over them. Then follows chills and shivers and a little fever... The night is passed in torture, sleeplessness, turning the part affected and perpetual change of posture; the tossing about of body being as incessant as the pain of the tortured joint and being worse as the fit comes on.

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at some point in their lifetimes and is becoming more common. Some 5.8 million people were affected in 2013. Rates of gout approximately doubled between 1990 and 2010. This rise is believed to be due to increasing life expectancy, changes in diet and an increase in diseases associated with gout, such

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Febuxostat is only recommended in those who cannot tolerate allopurinol. There are concerns about more deaths with febuxostat compared to allopurinol. Febuxostat may also increase the rate of gout flares during early treatment. However, there is tentative evidence that febuxostat may bring down urate

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While historically it is not recommended to start allopurinol during an acute attack of gout, this practice appears acceptable. Allopurinol blocks uric acid production, and is the most commonly used agent. Long term therapy is safe and well-tolerated and can be used in people with renal impairment or

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may be walled off by a ring of proteins, which blocks interaction of the crystals with cells and therefore avoids inflammation. Naked crystals may break out of walled-off tophi due to minor physical damage to the joint, medical or surgical stress, or rapid changes in uric acid levels. When they break

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are also associated with gout, the former more so when used in combination with hydrochlorothiazide. Hyperuricemia may be induced by excessive use of Vitamin D supplements. Levels of serum uric acid have been positively associated with 25(OH) D. The incidence of hyperuricemia increased 9.4% for every

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Physical fitness, healthy weight, low-fat dairy products, and to a lesser extent, coffee and taking vitamin C, appear to decrease the risk of gout; however, taking vitamin C supplements does not appear to have a significant effect in people who already have established gout. Peanuts, brown bread, and

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exist. It is not until this point that medications are cost-effective. They are not usually started until one to two weeks after an acute flare has resolved, due to theoretical concerns of worsening the attack. They are often used in combination with either an NSAID or colchicine for the first three

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Taiwan, Hong Kong and Singapore have releatively higher prevalence of gout. A study based on the National Health Insurance Research Database (NHIRD) estimated that 4.92% of Taiwanese residents have gout in 2004. A survey hold by the Hong Kong government found that 5.1% of Hong Kong resident between

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While it has been recommended that urate-lowering measures should be increased until serum uric acid levels are below 300–360 μmol/L (5.0–6.0 mg/dL), there is little evidence to support this practice over simply putting people on a standard dose of allopurinol. If these medications are in

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is affected most often, accounting for half of cases. Other joints, such as the heels, knees, wrists, and fingers, may also be affected. Joint pain usually begins during the night and peaks within 24 hours of onset. This is mainly due to lower body temperature. Other symptoms may rarely occur along

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Explore 2, no. 6 (2006): 515–519. - "Both the Ebers and Edwin Smith Papyri describe a condition that is clearly gout. They were written about 1552 BC but contain information taken from texts a thousand years earlier, and ascribed to Imhotep, a kind of ancient world Leonardo da Vinci, and the great

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Gouty patients are, generally, either old men or men who have so worn themselves out in youth as to have brought on a premature old age—of such dissolute habits none being more common than the premature and excessive indulgence in venery and the like exhausting passions. The victim goes to bed and

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develop gout at some point in their lifetimes. The risk, however, varies depending on the degree of hyperuricemia. When levels are between 415 and 530 μmol/L (7 and 8.9 mg/dL), the risk is 0.5% per year, while in those with a level greater than 535 μmol/L (9 mg/dL), the risk is

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NSAIDs are the usual first-line treatment for gout. No specific agent is significantly more or less effective than any other. Improvement may be seen within four hours and treatment is recommended for one to two weeks. They are not recommended for those with certain other health problems, such as

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The initial aim of treatment is to settle the symptoms of an acute attack. Repeated attacks can be prevented by medications that reduce serum uric acid levels. Tentative evidence supports the application of ice for 20 to 30 minutes several times a day to decrease pain. Options for acute treatment

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is an option for the 3% of people who are intolerant to other medications. It is a third line agent. Pegloticase is given as an intravenous infusion every two weeks, and reduces uric acid levels. Pegloticase is useful decreasing tophi but has a high rate of side effects and many people develop

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The triggers for precipitation of uric acid are not well understood. While it may crystallize at normal levels, it is more likely to do so as levels increase. Other triggers believed to be important in acute episodes of arthritis include cool temperatures, rapid changes in uric acid levels,

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Again thick urine, the sediment from which is white, indicates that pain and disease are to be apprehended in the region of joints or viscera... Joint troubles in the hands and feet are very frequent and persistent, such as occur in cases of podagra and cheiragra. These seldom attack

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is an alternative for those unable to tolerate NSAIDs. At high doses, side effects (primarily gastrointestinal upset) limit its usage. At lower doses, which are still effective, it is well tolerated. Colchicine may interact with other commonly prescribed drugs, such as

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Probenecid appears to be less effective than allopurinol and is a second line agent. Probenecid may be used if undersecretion of uric acid is present (24-hour urine uric acid less than 800 mg). It is, however, not recommended if a person has a history of

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is a classic feature of gout, but nearly half of the time gout occurs without hyperuricemia and most people with raised uric acid levels never develop gout. Thus, the diagnostic utility of measuring uric acid levels is limited. Hyperuricemia is defined as a

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reduces blood uric acid levels by preventing uric acid absorption in the kidneys. It was approved in the United States for use together with allopurinol, among those who were unable to reach their uric acid level targets. Side effects include

1774:) each mention arthritis of the first metacarpophalangeal joint as a distinct type of arthritis. These ancient manuscripts cite (now missing) Egyptian texts about gout that are claimed to have been written 1,000 years earlier and ascribed to 7514: 7499: 357:, longer life expectancy, and changes in diet. Older males are most commonly affected. Gout was historically known as "the disease of kings" or "rich man's disease". It has been recognized at least since the time of the ancient Egyptians. 7047: 6707:"Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013" 6329: 1172: 68: 67: 64: 69: 5665: 3088:

Ebrahimpour-Koujan S, Saneei P, Larijani B, et al. (2020). "Consumption of sugar sweetened beverages and dietary fructose in relation to risk of gout and hyperuricemia: a systematic review and meta-analysis".

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Gout affects about 1–2% of adults in the developed world at some point in their lives. It has become more common in recent decades. This is believed to be due to increasing risk factors in the population, such as

1515:, such as back pain, headache, and increased blood pressure. They, however, may work less well than usual doses of NSAIDS. The high cost of this class of drugs may also discourage their use for treating gout. 809:

proteins. The increased precipitation at low temperatures partly explains why the joints in the feet are most commonly affected. Rapid changes in uric acid may occur due to factors including trauma, surgery,

466:, the salts of uric acid. Underexcretion of uric acid by the kidney is the primary cause of hyperuricemia in about 90% of cases, while overproduction is the cause in less than 10%. About 10% of people with 6296: 66: 7759: 6558: 671:

greater than or equal to 35 increases male risk of gout threefold. Chronic lead exposure and lead-contaminated alcohol are risk factors for gout due to the harmful effect of lead on kidney function.

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Winzenberg T, Buchbinder R (2009). "Cochrane Musculoskeletal Group review: acute gout. Steroids or NSAIDs? Let this overview from the Cochrane Group help you decide what's best for your patient".

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Other than dietary and lifestyle choices, the recurrence of gout attacks is also linked to the weather. High ambient temperature and low relative humidity may increase the risk of a gout attack.

5798:"EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)" 7691: 7873: 6394:"Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial" 1713:. Some studies found that attacks of gout occur more frequently in the spring. This has been attributed to seasonal changes in diet, alcohol consumption, physical activity, and temperature. 1179: 1107: 6321: 1086:(ESR). However, both the white blood cells and ESR may be elevated due to gout in the absence of infection. A white blood cell count as high as 40.0×10/l (40,000/mm) has been documented. 1529:

Without treatment, an acute attack of gout usually resolves in five to seven days; however, 60% of people have a second attack within one year. Those with gout are at increased risk of

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is generally the recommended preventative treatment if medications are used. A number of other medications may occasionally be considered to prevent further episodes of gout, including

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Dietary causes account for about 12% of gout, and include a strong association with the consumption of alcohol, sugar-sweetened beverages, meat, and seafood. Among foods richest in

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chronic use at the time of an attack, it is recommended that they be continued. Levels that cannot be brought below 6.0 mg/dL while attacks continue indicates refractory gout.

6202:"Safety of colchicine and NSAID prophylaxis when initiating urate-lowering therapy for gout: propensity score-matched cohort studies in the UK Clinical Practice Research Datalink" 1717:

45–59 years and 6.1% of those older than 60 years have gout. A study hold in Singapore found that 2,117 in 52,322 people between 45–74 years have gout, roughly equals to 4.1%.

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and thus are at increased risk of death. It is unclear whether medications that lower urate affect cardiovascular disease risks. This may be partly due to its association with

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Gout may be diagnosed and treated without further investigations in someone with hyperuricemia and the classic acute arthritis of the base of the great toe (known as podagra).

310:, and surrounding tissues, resulting in an attack of gout. Gout occurs more commonly in those who regularly drink beer or sugar-sweetened beverages; eat foods that are high in 8078: 1622: 6980:

Randolphus of Bocking was the first to use the word 'gout' to express the clinical signs of podagra. Bocking was the domestic chaplain to Bishop of Chichester (1197-1258).

7752: 6916: 1054:. This test is difficult to perform and requires a trained observer. The fluid must be examined relatively soon after aspiration, as temperature and pH affect solubility. 1449:, may be preferred due to its better side effect profile in the absence of superior effectiveness. For those at risk of gastric side effects from NSAIDs, an additional 1725: 462:, often related to relatively high levels in the blood, is the underlying cause of gout. This can occur because of diet, genetic predisposition, or underexcretion of 5657: 600: 306:). This occurs from a combination of diet, other health problems, and genetic factors. At high levels, uric acid crystallizes and the crystals deposit in joints, 5768: 7745: 1813:

or boys before coition with a woman, or women except those in whom the menses have become suppressed... some have obtained lifelong security by refraining from

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also frequently complicate gout, affecting between 10 and 40% of people, and occur due to low urine pH promoting the precipitation of uric acid. Other forms of

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is not effective for tophi resolution. Potential side effects include kidney stones, anemia and joint pain. In 2016, it was withdrawn from the European market.

6272: 5502:"Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials" 1759:

Gout has been known since antiquity. Historically, wits have referred to it as "the king of diseases and the disease of kings" or as "rich man's disease". The

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is also important. Lifestyle interventions have been poorly studied. It is unclear whether dietary supplements have an effect in people with gout.

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urate level greater than 420 μmol/L (7.0 mg/dL) in males and 360 μmol/L (6.0 mg/dL) in females. Other blood tests commonly performed are

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Virsaladze DK, Tetradze LO, Dzhavashvili LV, et al. (2007). "" [Levels of uric acid in serum in patients with metabolic syndrome].

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improves symptoms. Once the acute attack subsides, levels of uric acid can be lowered via lifestyle changes and in those with frequent attacks,

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Studies in the early 2000s found that other dietary factors are not relevant. Specifically, a diet with moderate purine-rich vegetables (e.g.,

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Park KY, Kim HJ, Ahn HS, et al. (April 2016). "Effects of coffee consumption on serum uric acid: systematic review and meta-analysis".

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Without treatment, episodes of acute gout may develop into chronic gout with destruction of joint surfaces, joint deformity, and painless

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are usually normal and are not useful for confirming a diagnosis of early gout. They may show signs of chronic gout such as bone erosion.

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have been found to be as effective as NSAIDs and may be used if contraindications exist for NSAIDs. They also lead to improvement when

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of a left foot in the metatarsal-phalangeal joint of the big toe. Note also the soft tissue swelling at the lateral border of the foot.

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do not have this ability; thus, gout is common. Other animals with uricase include fish, amphibians and most non-primate mammals. The

1686:. Factors that influence rates of gout include age, race, and the season of the year. In men over 30 and women over 50, rates are 2%. 1311: 7069: 5937: 1658: 6961: 6325: 4476: 4454: 1956: 1280:. Long term medications are not recommended until a person has had two attacks of gout, unless destructive joint changes, tophi, or 248: 7030: 3523:"Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men" 4583: 7889: 314:

such as liver, shellfish, or anchovies; or are overweight. Diagnosis of gout may be confirmed by the presence of crystals in the

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Kuo CF, Grainge MJ, Zhang W, et al. (7 July 2015). "Global epidemiology of gout: prevalence, incidence and risk factors".

3973:"Association between serum vitamin D and uric acid in the eastern Chinese population: a population-based cross-sectional study" 3333: 592: 7696: 1083: 7985: 7179: 6967: 6755: 530:. Alcohol consumption is strongly associated with increased risk, with wine presenting somewhat less of a risk than beer or 6102:

van Durme CM, Wechalekar MD, Landewé RB (9 June 2015). "Nonsteroidal anti-inflammatory drugs for treatment of acute gout".

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Stamp L, Searle M, O'Donnell J, et al. (2005). "Gout in solid organ transplantation: a challenging clinical problem".

3134:"Total Purine and Purine Base Content of Common Foodstuffs for Facilitating Nutritional Therapy for Gout and Hyperuricemia" 7956: 6434: 5154:"Drug Safety and Availability – FDA adds Boxed Warning for increased risk of death with gout medicine Uloric (febuxostat)" 1736:

The English term "gout" first occurs in the work of Randolphus of Bocking, around 1200 AD. It derives from the Latin word

1166:, with yellow color when aligned parallel to the axis of the red compensator, and blue when aligned perpendicularly to it. 6666:"Cardiovascular effects of urate-lowering therapies in patients with chronic gout: a systematic review and meta-analysis" 5009: 4608:"Fructose intake and risk of gout and hyperuricemia: a systematic review and meta-analysis of prospective cohort studies" 1837:, an English physician, described its occurrence in the early hours of the morning and its predilection for older males: 587:

causes low blood uric acid levels by reducing urate absorption and unopposed urate secretion. The rare genetic disorders

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must be excluded, however, as glucocorticoids worsen this condition. There were no short-term adverse effects reported.

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Wechalekar MD, Vinik O, Schlesinger N, et al. (30 April 2013). "Intra-articular glucocorticoids for acute gout".

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Firestein GS, Budd RC, Harris ED, McInnes IB, Ruddy S, Sergent JS, eds. (2008). "Chapter 87: Gout and Hyperuricemia".

1281: 427: 7155: 5713: 4168: 2656:"Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline" 79: 6247: 5131: 2992: 575:

genes have been found to be commonly associated with gout and variations in them can approximately double the risk.

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and diuretics. The starting or increasing of urate-lowering medications can lead to an acute attack of gout with

754: 576: 385: 370: 272: 268: 2957:"SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout" 1610: 1342:. Probenecid can be used in a combined therapy with allopurinol is more effective than allopurinol monotherapy. 604: 7912: 7552: 7378: 4972:"Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians" 2391:"Management of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians" 1252:

via the release of purines from oxygen-starved cells. Treatment of apnea can lessen the occurrence of attacks.

1221: 7409: 4374: 1875: 1787: 1729: 1511:, showed moderate effectiveness for pain relief and reduction of joint swelling, but have increased risk of 1301: 819: 5478: 3182:"Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts" 1693:, gout is twice as likely in males of African descent than those of European descent. Rates are high among 7980: 7907: 4799:

Dakkak M, Lanney H (August 2021). "Management of Gout: Update from the American College of Rheumatology".

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It has been referred to, maybe a touch inaccurately, as 'The disease of kings and the king of diseases.'

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The Gout is a chronical disease most commonly affecting the feet. If it attacks the knees, it is called

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Choi HK (March 2010). "A prescription for lifestyle change in patients with hyperuricemia and gout".

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Schlesinger N (March 2010). "Diagnosing and treating gout: a review to aid primary care physicians".

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first described the microscopic appearance of urate crystals in 1679. In 1848, English physician

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due to bone erosion. Elevated levels of uric acid may also lead to crystals precipitating in the

354: 107: 8015: 6499: 4302:"Diagnosis of Acute Gout: A Clinical Practice Guideline From the American College of Physicians" 757:

and forming deposits (tophi) in joints, on tendons, and in the surrounding tissues. Microscopic

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Therapeutics: Or, the Art of Healing: To which is Added, a Glossary of the Most Difficult Words

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Gout complicated by ruptured tophi, the exudate of which tested positive for uric acid crystals

408:) may result in other symptoms, including hard, painless deposits of uric acid crystals called 7868: 7592: 7563: 7462: 7362: 7305: 7262: 7224: 7127: 6957: 6928: 6890: 6882: 6847: 6812: 6736: 6687: 6646: 6616: 6550: 6532: 6480: 6472: 6426: 6374: 6239: 6221: 6179: 6161: 6119: 6084: 6033: 6003: 5985: 5921: 5879: 5827: 5639: 5621: 5582: 5533: 5457: 5400: 5359: 5307: 5301: 5279: 5261: 5222: 5204: 5094: 5067: 5040: 4993: 4952: 4911: 4893: 4850: 4808: 4781: 4727: 4686: 4637: 4556: 4507: 4428: 4401: 4350: 4323: 4275: 4246: 4240: 4221: 4139: 4112: 4085: 4062: 4004: 3951: 3928: 3882: 3817: 3782: 3730: 3691: 3673: 3634: 3591: 3553: 3495: 3460: 3442: 3395: 3360: 3304: 3251: 3211: 3155: 3106: 3062: 2976: 2937: 2877: 2831: 2756: 2677: 2593: 2537: 2480: 2412: 2363: 2261: 2215: 2173: 2111: 2022: 2016: 1983: 1977: 1900: 1534: 746: 624: 394: 292: 95: 5735: 5124:"Febuxostat for the management of hyperuricaemia in people with gout Guidance and guidelines" 7845: 7837: 7452: 7444: 7352: 7301: 7297: 7254: 7214: 6874: 6839: 6802: 6794: 6726: 6718: 6677: 6606: 6598: 6540: 6522: 6514: 6464: 6416: 6408: 6364: 6356: 6280: 6273:"How common are side-effects of treatment to prevent gout flares when starting allopurinol?" 6229: 6213: 6169: 6153: 6111: 6074: 6064: 5993: 5975: 5913: 5869: 5861: 5817: 5809: 5629: 5613: 5572: 5564: 5523: 5513: 5447: 5439: 5392: 5269: 5253: 5212: 5196: 4983: 4942: 4901: 4885: 4842: 4771: 4761: 4717: 4676: 4668: 4627: 4619: 4546: 4538: 4499: 4391: 4383: 4313: 4211: 4203: 4052: 3994: 3984: 3918: 3872: 3856: 3809: 3772: 3764: 3722: 3681: 3665: 3626: 3583: 3543: 3535: 3487: 3450: 3434: 3387: 3350: 3342: 3294: 3286: 3243: 3201: 3193: 3145: 3098: 3054: 2968: 2927: 2919: 2869: 2746: 2738: 2667: 2585: 2527: 2519: 2472: 2402: 2355: 2253: 2207: 2163: 2103: 1565: 1493: 1099: 936: 656: 648: 538:

fruit also appear protective. This is believed to be partly due to their effect in reducing

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The Essentials of Charcot Neuroarthropathy: Biomechanics, Pathophysiology, and MRI Findings

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Agudelo CA, Wise CM (2001). "Gout: diagnosis, pathogenesis, and clinical manifestations".

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Gout can present in several ways, although the most common is a recurrent attack of acute

7940: 5898: 4469:"Gout and Pseudogout: Differential Diagnoses & Workup – eMedicine Emergency Medicine" 4468: 4446: 271:. Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours. The 7457: 7432: 7348: 7022: 6611: 6586: 6234: 4906: 4877: 4527:"Atypical Triggering at the Wrist due to Intratendinous Infiltration of Tophaceous Gout" 734: 8010: 7792: 7523: 7169: 6807: 6782: 6731: 6706: 6545: 6421: 6369: 6344: 6174: 6141: 6079: 6052: 5998: 5963: 5874: 5849: 5822: 5797: 5634: 5601: 5577: 5552: 5452: 5431: 5274: 5241: 5217: 5184: 4722: 4705: 4681: 4656: 4632: 4607: 4575: 4551: 4526: 4396: 4369: 4216: 4191: 3999: 3923: 3906: 3877: 3844: 3777: 3752: 3710: 3686: 3653: 3548: 3522: 3455: 3422: 3355: 3328: 3206: 3181: 3177: 2932: 2907: 2860:

Terkeltaub R (January 2010). "Update on gout: new therapeutic strategies and options".

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may work as well as nonselective NSAIDs for acute gout attack with fewer side effects.

1434: 1401: 1376: 1213: 1043: 1035: 1015: 881: 644: 640: 639:, occurs in nearly 75% of cases. Other conditions commonly complicated by gout include 496: 330: 315: 260: 205: 116: 31: 7532: 7529: 7526: 7288:

Choi HK, Mount DB, Reginato AM, et al. (4 October 2005). "Pathogenesis of gout".

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urate stones, although hypersensitivity occurs in a small number of individuals. The

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Jordan DR, Belliveau MJ, Brownstein S, et al. (2008). "Medial canthal tophus".

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Moyer RA, John DS (2003). "Acute gout precipitated by total parenteral nutrition".

3438: 3074: 2988: 1753: 1556:. These tophi occur in 30% of those who are untreated for five years, often in the 1530: 1519: 1474: 1470: 1380: 1339: 1315: 1067: 974: 900: 827: 811: 778: 767: 711: 703: 664: 636: 628: 423: 288: 100: 7317: 6682: 6665: 4947: 4930: 3102: 2168: 2151: 7557: 7173: 6951: 6759: 4503: 4419:

Sachs L, Batra KL, Zimmermann B (2009). "Medical implications of hyperuricemia".

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does not seem to increase risk. Other medications that increase the risk include

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Benjamin Welles, an English physician, authored the first medical book on gout,

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Beyl RN Jr, Hughes L, Morgan S (2016). "Update on Importance of Diet in Gout".

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Gentleman Revolutionary: Gouverneur Morris, the Rake Who Wrote the Constitution

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may help prevent gout attacks, as does losing weight. Gout may be secondary to

789:, one of the key proteins in the inflammatory cascade. An evolutionary loss of 8025: 7813: 7624: 7612: 7606: 6830:

Fam AG (May 2000). "What is new about crystals other than monosodium urate?".

5058:

Robinson PC, Stamp LK (May 2016). "The management of gout: Much has changed".

4971: 4542: 2923: 2742: 1925: 1895: 1465: 1413: 1409: 1397: 1357: 1277: 1269: 1265: 1126:. Gouty tophi, in particular when not located in a joint, can be mistaken for 1103: 815: 722: 500: 488: 342: 334: 209: 175: 131: 112: 7721:. Vol. 12 (11th ed.). Cambridge University Press. pp. 289–291. 6886: 6536: 6476: 6225: 6165: 5989: 5625: 5265: 5208: 4897: 4657:"An old disease with new insights: Update on diagnosis and treatment of gout" 4387: 3768: 3677: 3539: 3446: 3329:"Risk factors for gout and prevention: a systematic review of the literature" 2873: 2695: 2589: 1106:

and culture may be performed. Other conditions that can look similar include

7782: 7598: 7508: 6878: 6217: 5813: 5085:

Dean L, Kane M (2012), Pratt VM, Scott SA, Pirmohamed M, Esquivel B (eds.),

4750:"2020 American College of Rheumatology Guideline for the Management of Gout" 4041:"Evil humors take their Toll as innate immunity makes gouty joints TREM-ble" 3654:"Relation of Temperature and Humidity to the Risk of Recurrent Gout Attacks" 2438: 1944: 1859: 1706: 1561: 1446: 1445:

has historically been the most commonly used NSAID, an alternative, such as

1371: 1350: 1237: 994: 955: 782: 750: 739: 707: 652: 463: 459: 447: 415: 401: 346: 299: 264: 142: 7649: 7466: 7309: 7266: 7228: 7147: 6932: 6894: 6851: 6816: 6740: 6691: 6650: 6620: 6554: 6484: 6430: 6378: 6243: 6183: 6123: 6115: 6088: 6037: 6007: 5925: 5883: 5831: 5643: 5586: 5537: 5518: 5501: 5461: 5404: 5283: 5226: 5098: 5071: 5044: 4997: 4956: 4915: 4854: 4812: 4785: 4731: 4690: 4641: 4560: 4511: 4432: 4405: 4354: 4327: 4279: 4225: 4160: 4116: 4089: 4066: 4008: 3932: 3821: 3786: 3734: 3695: 3638: 3595: 3557: 3499: 3464: 3399: 3364: 3308: 3255: 3215: 3159: 3110: 3066: 2980: 2941: 2881: 2835: 2760: 2681: 2597: 2541: 2484: 2416: 2367: 2265: 2219: 2177: 2152:"The British Society for Rheumatology Guideline for the Management of Gout" 2115: 826:

are associated with a lower risk of gout compared to other medications for

7366: 5917: 5709: 4776: 4143: 3886: 3282:"Purine-rich foods, dairy and protein intake, and the risk of gout in men" 3150: 3133: 2257: 1855: 1182:(pseudogout) displays rhombus-shaped crystals with positive birefringence. 1042:. All synovial fluid samples obtained from undiagnosed inflamed joints by 90:, 1799), which depicts the pain of the artist's gout as a demon or dragon. 6950:

Pierre-Jerome C (11 May 2022). "8.5: Gout and Charcot neuroarthropathy".

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From Hogarth to Rowlandson: medicine in art in eighteenth-century Britain

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A number of new medications are under study for treating gout, including

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van Durme CM, Wechalekar MD, Landewé RB, et al. (9 December 2021).

5687:"Pegloticase: withdrawal of its EU marketing authorisation is welcome". 1863: 7629: 6498:

Janssens HJ, Lucassen PL, Van de Laar FA, et al. (23 April 2008).

6343:

McKenzie BJ, Wechalekar MD, Johnston RV, et al. (26 August 2021).

3868: 1932: 1891: 1867: 1793: 1775: 1549:

and obesity, but some of the increased risk appears to be independent.

1319: 1294: 1229: 794: 691: 596: 523: 519: 484: 480: 17: 7669:

Knowledge (XXG)'s health care articles can be viewed offline with the

7491: 6992: 6917:"Hyperuricemia and gout: new insights into pathogenesis and treatment" 6527: 5848:

Moi JH, Sriranganathan MK, Edwards CJ, et al. (4 November 2013).

5528: 4766: 4749: 4207: 4057: 4040: 3391: 3197: 259:

characterized by recurrent attacks of pain in a red, tender, hot, and

7737: 7700: 7503: 7357: 5093:, Bethesda (MD): National Center for Biotechnology Information (US), 4988: 4318: 4301: 2700:

National Institute of Arthritis and Musculoskeletal and Skin Diseases

2672: 2655: 2407: 2390: 1940: 1810: 1589: 1553: 1245: 1241: 1225: 1195: 1147: 1039: 763: 758: 559: 443: 419: 409: 389: 374: 319: 311: 307: 284: 276: 7726: 7332: 4447:"Gout: Differential Diagnoses & Workup – eMedicine Rheumatology" 3860: 1640:

Gout in the big toe of left foot, compared to the healthy right foot

365: 349:

and having a diet high in low-fat dairy products may be preventive.

7431:

Sivera F, Wechalekar MD, Andrés M, et al. (1 September 2014).

6069: 2972: 1890:

Gout is rare in most other animals due to their ability to produce

1732:

described the microscopic appearance of uric acid crystals in 1679.

1050:

microscopy, they have a needle-like morphology and strong negative

1030:

A definitive diagnosis of gout is based upon the identification of

503:. Chicken and potatoes also appear related. Other triggers include 5962:

Andrés M, Sivera F, Buchbinder R, et al. (12 November 2021).

5306:. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 251. 3421:

Moi JH, Sriranganathan MK, Edwards CJ, et al. (31 May 2013).

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1818: 1814: 1752:

and "the notion of the 'dropping' of a morbid material from the

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4876:

Kydd AS, Seth R, Buchbinder R, et al. (14 November 2014).

4748:

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2389:

Qaseem A, Harris RP, Forciea MA, et al. (3 January 2017).

1882:

identified excess uric acid in the blood as the cause of gout.

1416:. Lowering uric acid levels can cure the disease. Treatment of 7930: 5240:

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4300:

Qaseem A, McLean RM, Starkey M, et al. (3 January 2017).

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have been associated with attacks of gout, but a low dose of

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4833:

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analysis should be done if the diagnosis is in doubt. Plain

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5379:

Stocker SL, Williams KM, McLachlan AJ, et al. (2008).

3280:

Choi HK, Atkinson K, Karlson EW, et al. (March 2004).

1364:

with febuxostat, with similar side effects. Lesinural plus

1314:

during treatment with allopurinol and is most common among

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Kim SY, De Vera MA, Choi HK (2008). "Gout and mortality".

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Free Online Medical Dictionary, Thesaurus and Encyclopedia

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Further information on the investigational new drug:

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Sano K, Kohakura Y, Kimura K, et al. (March 2009).

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presenting as nodules on the finger and helix of the ear

1162:

Uric acid crystals in polarized light, showing negative

6585:

Sivera F, Wechalekar MD, Andrés M, et al. (2014).

1360:

is more beneficial for tophi resolution than lesinural

7124:

A Short History of the Gout and the Rheumatic Diseases

6142:"Non-steroidal anti-inflammatory drugs for acute gout" 3652:

Neogi T, Chen C, Niu J, et al. (15 August 2014).

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Roberts-Thomson RA, Roberts-Thomson PJ (1 May 1999).

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Vos T, Barber RM, Bell B, et al. (August 2015).

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JAMA: The Journal of the American Medical Association

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Gout is partly genetic, contributing to about 60% of

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Skin conditions resulting from errors in metabolism

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With aggressive treatment, they may dissolve. 785:, which converts pro-interleukin 1β into active 753:, crystallizes in the form of monosodium urate, 283:) in about half of cases. It may also result in 6997:Oxford English Dictionary, Second edition, 1989 6921:Bulletin of the NYU Hospital for Joint Diseases 5791: 5789: 5767:. European Medicines Agency. 18 February 2016. 3746: 3744: 3327:Singh JA, Reddy SG, Kundukulam J (March 2011). 3234:Weaver AL (July 2008). "Epidemiology of gout". 1839: 1806: 726:10 nmol/L increase in 25(OH) D (P < 0.001). 298:Gout is due to persistently elevated levels of 7126:. University of California Press. p. 68. 6316: 6314: 5087:"Allopurinol Therapy and HLA-B*58:01 Genotype" 2463:, Merriman TR, Stamp LK (April 2016). "Gout". 2094:, Merriman TR, Stamp LK (April 2016). 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Under 483:yielding high amounts of uric acid are dried 154:Diet high in meat or beer, being overweight, 8: 7962:Systemic-onset juvenile idiopathic arthritis 7331:Rothschild BM, Tanke D, Carpenter K (1997). 3322: 3320: 3318: 3040: 3038: 3036: 3034: 3032: 3030: 2293: 2291: 2289: 2287: 2285: 2283: 2281: 2279: 2277: 2275: 7437:The Cochrane Database of Systematic Reviews 6580: 6578: 6576: 6349:The Cochrane Database of Systematic Reviews 6146:The Cochrane Database of Systematic Reviews 5968:The Cochrane Database of Systematic Reviews 5854:The Cochrane Database of Systematic Reviews 5557:The Cochrane Database of Systematic Reviews 5436:The Cochrane Database of Systematic Reviews 4743: 4741: 4341:Schlesinger N (2007). 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Neither is 53:Arthritis uratica, or Podagra when of the 41: 7456: 7433:"Interleukin-1 inhibitors for acute gout" 7356: 7218: 7051:overarching figure of Egyptian medicine." 6806: 6730: 6681: 6610: 6587:"Interleukin-1 inhibitors for acute gout" 6544: 6526: 6500:"Systemic corticosteroids for acute gout" 6420: 6368: 6233: 6173: 6078: 6068: 5997: 5979: 5873: 5821: 5633: 5576: 5527: 5517: 5451: 5273: 5216: 4987: 4946: 4905: 4878:"Uricosuric medications for chronic gout" 4775: 4765: 4721: 4680: 4631: 4550: 4395: 4317: 4215: 4056: 3998: 3988: 3922: 3876: 3776: 3753:"The genetics of hyperuricaemia and gout" 3685: 3547: 3454: 3354: 3298: 3205: 3149: 2931: 2750: 2671: 2569: 2567: 2565: 2563: 2561: 2559: 2557: 2555: 2553: 2551: 2531: 2406: 2167: 2145: 2143: 2141: 2139: 2137: 2135: 2133: 1862:; if the elbow, Onagra; if the shoulder, 384:(a red, tender, hot, swollen joint). The 369:Gout presenting as slight redness in the 7690:) is being considered for deletion. 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Easy to misdiagnose" 4306:Annals of Internal Medicine 4105:The Journal of Rheumatology 4084:(in Russian) (146): 35–37. 3757:Nature Reviews Rheumatology 2862:Nature Reviews Rheumatology 2660:Annals of Internal Medicine 2395:Annals of Internal Medicine 2246:Annals of Internal Medicine 2169:10.1093/rheumatology/kex156 1616:Tophii on the toe and ankle 839:Synovial fluid examination 607:, are complicated by gout. 428:acute uric acid nephropathy 8105: 7201:Storey GD (October 2001). 6285:10.3310/nihrevidence_62005 5091:Medical Genetics Summaries 4045:Arthritis & Rheumatism 3990:10.1186/s12902-020-00560-1 3950:(8th ed.). Elsevier. 3248:10.3949/ccjm.75.Suppl_5.S9 1682:as metabolic syndrome and 1574:chronic kidney dysfunction 1517: 1418:associated health problems 805:, articular hydration and 577:Loss-of-function mutations 29: 7154:. BBC. 23 December 2012. 7048:"Disease of distinction." 6645:(5 Suppl 51): S115–S119. 5385:Clinical Pharmacokinetics 4543:10.1007/s11552-008-9120-4 4274:. StatPearls Publishing. 4268:"Synovial Fluid Analysis" 2924:10.3238/arztebl.2009.0549 2743:10.1016/j.rdc.2014.01.001 1745:Oxford English Dictionary 1431:gastrointestinal bleeding 1216:, reducing the intake of 1032:monosodium urate crystals 992: 426:formation and subsequent 386:metatarsophalangeal joint 371:metatarsophalangeal joint 320:deposit outside the joint 269:monosodium urate crystals 77: 60: 7913:Enteropathic arthropathy 7692:templates for discussion 4388:10.1136/bmj.320.7228.132 4245:. US: OUP. p. 400. 3849:Environ. Health Perspect 3769:10.1038/nrrheum.2012.144 3521:Williams PT (May 2008). 2874:10.1038/nrrheum.2009.236 2590:10.3810/pgm.2010.03.2133 1866:; if the back or loins, 1792:, noting its absence in 1349:resistance to it. Using 1222:high fructose corn syrup 820:Calcium channel blockers 694:(acetylsalicylic acid), 557:in uric acid level. The 7718:Encyclopædia Britannica 6879:10.1038/nrrheum.2015.91 6218:10.1136/ard-2023-224154 5814:10.1136/ard.2006.055269 5689:Prescrire International 2624:www.merriam-webster.com 2620:"Definition of Podagra" 1876:Antonie van Leeuwenhoek 1748:, this originates from 1730:Antonie van Leeuwenhoek 1490:injected into the joint 1302:human leukocyte antigen 716:immunosuppressive drugs 657:solid organ transplants 615:Gout frequently occurs 400:Long-standing elevated 7981:Palindromic rheumatism 7908:Ankylosing spondylitis 7851:Tuberculosis arthritis 7023:"The Disease Of Kings" 6116:10.1001/jama.2015.1881 5695:(180): 71. March 2017. 5519:10.1001/jama.2011.1169 3540:10.1093/ajcn/87.5.1480 3176:Major TJ, Topless RK, 3091:Crit Rev Food Sci Nutr 2727:"Epidemiology of gout" 1872: 1844: 1827: 1802:Aulus Cornelius Celsus 1738: 1733: 1699:aboriginal Australians 1543:cardiovascular disease 1120:palindromic rheumatism 1096:differential diagnosis 1090:Differential diagnosis 1072:white blood cell count 745:Gout is a disorder of 742: 738:Chemical structure of 603:deficiency as seen in 451: 382:inflammatory arthritis 377: 302:(urate) in the blood ( 257:inflammatory arthritis 219:1–2% (developed world) 163:Differential diagnosis 7097:University of Chicago 7046:Schwartz, Stephan A. 5918:10.3899/jrheum.170137 5485:. 14 September 2010. 4935:Postgraduate Medicine 4596:Updated: Jun 30, 2020 3151:10.1248/bpb.b13-00967 2258:10.7326/AITC201607050 1976:Brookhiser R (2008). 1852: 1846:In the 18th century, 1728: 1564:processes, or on the 1560:of the ear, over the 1451:proton pump inhibitor 737: 637:abnormal lipid levels 528:total dietary protein 441: 368: 7969:Rheumatoid arthritis 6939:on 16 December 2008. 6799:10.1136/ard.58.5.266 6639:Clin. Exp. Rheumatol 5160:. 21 February 2019. 5130:. 17 December 2008. 4841:(10055): 2039–2052. 3300:10.1056/NEJMoa035700 3053:(5 Suppl): S55–S62. 2471:(10055): 2039–2052. 2102:(10055): 2039–2052. 1880:Alfred Baring Garrod 1833:, in 1669. In 1683, 1507:inhibitors, such as 1128:basal cell carcinoma 1112:rheumatoid arthritis 1003:rheumatoid arthritis 807:extracellular matrix 605:Lesch–Nyhan syndrome 172:rheumatoid arthritis 7903:Psoriatic arthritis 7349:1997Natur.387..357R 7247:Curr Opin Rheumatol 6832:Curr Opin Rheumatol 6279:. 6 February 2024. 4475:. 17 January 2019. 4453:. 17 January 2019. 4368:Sturrock R (2000). 3576:Curr Opin Rheumatol 3480:Curr Opin Rheumatol 3242:(Suppl 5): S9–S12. 1904:specimen known as " 1765:Edwin Smith papyrus 1684:high blood pressure 1214:alcoholic beverages 1210:complete abstinence 1116:psoriatic arthritis 1094:The most important 840: 684:hydrochlorothiazide 623:, a combination of 388:at the base of the 275:at the base of the 7936:systemic sclerosis 7898:Reactive arthritis 7769:Diseases of joints 7579:External resources 7122:Copeman W (2021). 3670:10.1093/aje/kwu147 3528:Am. J. Clin. Nutr. 3386:(oct01 3): f5648. 2918:(34–35): 549–555. 2441:on 19 October 2019 1734: 1711:Sub-Saharan Africa 1604:Tophus of the knee 1547:insulin resistance 1539:metabolic syndrome 1124:reactive arthritis 838: 743: 633:insulin resistance 621:Metabolic syndrome 611:Medical conditions 599:superactivity and 540:insulin resistance 452: 378: 361:Signs and symptoms 355:metabolic syndrome 130:Older males, post- 8036: 8035: 7994: 7993: 7869:Chondrocalcinosis 7659: 7658: 7646:Wheeless textbook 7213:(10): 1189–1190. 7133:978-0-520-33947-7 6717:(9995): 743–800. 6212:(12): 1618–1625. 6110:(22): 2276–2277. 5808:(10): 1312–1324. 5662:www.ema.europa.eu 5313:978-0-7817-7153-5 4767:10.1002/art.41247 4704:Abrams B (2009). 4382:(7228): 132–133. 4252:978-0-19-991494-4 4208:10.1136/bmj.d8190 4082:Georgian Med News 4058:10.1002/art.21634 3977:BMC Endocr Disord 3957:978-1-4160-4842-8 3917:(12): 1209–1212. 3911:Can Fam Physician 3808:(18): 2593–2611. 3392:10.1136/bmj.f5648 3293:(11): 1093–1103. 3198:10.1136/bmj.k3951 2912:Dtsch Ärztebl Int 2512:Clinical Medicine 2354:(9711): 318–328. 2206:(11): 1153–1158. 2028:978-0-85323-640-5 2015:Haslam F (1996). 1989:978-1-4391-0408-8 1901:Tyrannosaurus rex 1667:of a large tophus 1541:, and kidney and 1535:diabetes mellitus 1282:urate nephropathy 1012: 1011: 747:purine metabolism 625:abdominal obesity 223: 222: 71: 39:Medical condition 16:(Redirected from 8096: 8021:Bouchard's nodes 7974:Felty's syndrome 7846:Septic arthritis 7834: 7762: 7755: 7748: 7739: 7734: 7722: 7714: 7667: 7483: 7471: 7470: 7460: 7428: 7422: 7421: 7419: 7417: 7408:. Archived from 7397: 7391: 7390: 7388: 7386: 7360: 7358:10.1038/387357a0 7328: 7322: 7321: 7285: 7279: 7278: 7242: 7233: 7232: 7222: 7198: 7192: 7191: 7189: 7187: 7166: 7160: 7159: 7144: 7138: 7137: 7119: 7113: 7112: 7110: 7108: 7088: 7082: 7081: 7079: 7077: 7058: 7052: 7044: 7038: 7037: 7019: 7013: 7012: 7010: 7008: 6989: 6983: 6982: 6977: 6975: 6947: 6941: 6940: 6935:. Archived from 6912: 6899: 6898: 6862: 6856: 6855: 6827: 6821: 6820: 6810: 6778: 6772: 6771: 6769: 6767: 6762:on 25 March 2007 6758:. Archived from 6751: 6745: 6744: 6734: 6702: 6696: 6695: 6685: 6676:(7): 1144–1153. 6661: 6655: 6654: 6634: 6625: 6624: 6614: 6582: 6571: 6570: 6568: 6566: 6548: 6530: 6504: 6495: 6489: 6488: 6456: 6450: 6449: 6447: 6445: 6439: 6424: 6398: 6389: 6383: 6382: 6372: 6340: 6334: 6333: 6318: 6309: 6308: 6306: 6304: 6269: 6260: 6259: 6257: 6255: 6237: 6197: 6188: 6187: 6177: 6152:(12): CD010120. 6137: 6128: 6127: 6099: 6093: 6092: 6082: 6072: 6048: 6042: 6041: 6021: 6012: 6011: 6001: 5983: 5974:(11): CD010156. 5959: 5953: 5952: 5950: 5948: 5942: 5903: 5894: 5888: 5887: 5877: 5860:(11): CD010519. 5845: 5836: 5835: 5825: 5793: 5784: 5783: 5781: 5779: 5773: 5766: 5758: 5752: 5751: 5749: 5747: 5732: 5726: 5725: 5723: 5721: 5706: 5697: 5696: 5684: 5678: 5677: 5675: 5673: 5654: 5648: 5647: 5637: 5597: 5591: 5590: 5580: 5548: 5542: 5541: 5531: 5521: 5497: 5491: 5490: 5475: 5466: 5465: 5455: 5438:(10): CD006077. 5427: 5421: 5420: 5418: 5416: 5376: 5370: 5369: 5363: 5355: 5353: 5351: 5336: 5330: 5329: 5327: 5325: 5297: 5288: 5287: 5277: 5252:(10): CD006077. 5237: 5231: 5230: 5220: 5195:(11): CD008653. 5180: 5174: 5173: 5171: 5169: 5150: 5144: 5143: 5141: 5139: 5120: 5114: 5113: 5112: 5110: 5082: 5076: 5075: 5055: 5049: 5048: 5028: 5022: 5021: 5019: 5017: 4991: 4989:10.7326/M16-0570 4967: 4961: 4960: 4950: 4926: 4920: 4919: 4909: 4884:(11): CD010457. 4873: 4867: 4866: 4830: 4817: 4816: 4801:Am Fam Physician 4796: 4790: 4789: 4779: 4769: 4745: 4736: 4735: 4725: 4701: 4695: 4694: 4684: 4652: 4646: 4645: 4635: 4603: 4597: 4595: 4593: 4591: 4571: 4565: 4564: 4554: 4522: 4516: 4515: 4487: 4481: 4480: 4465: 4459: 4458: 4443: 4437: 4436: 4416: 4410: 4409: 4399: 4365: 4359: 4358: 4338: 4332: 4331: 4321: 4319:10.7326/m16-0569 4297: 4291: 4290: 4288: 4286: 4263: 4257: 4256: 4236: 4230: 4229: 4219: 4187: 4181: 4180: 4178: 4176: 4157: 4148: 4147: 4127: 4121: 4120: 4100: 4094: 4093: 4077: 4071: 4070: 4060: 4036: 4025: 4024: 4022: 4020: 4002: 3992: 3968: 3962: 3961: 3943: 3937: 3936: 3926: 3902: 3891: 3890: 3880: 3840: 3834: 3833: 3797: 3791: 3790: 3780: 3748: 3739: 3738: 3715:Joint Bone Spine 3706: 3700: 3699: 3689: 3649: 3643: 3642: 3614: 3608: 3607: 3571: 3562: 3561: 3551: 3534:(5): 1480–1487. 3518: 3512: 3511: 3475: 3469: 3468: 3458: 3418: 3412: 3411: 3375: 3369: 3368: 3358: 3324: 3313: 3312: 3302: 3287:N. Engl. J. Med. 3277: 3268: 3267: 3231: 3220: 3219: 3209: 3173: 3164: 3163: 3153: 3129: 3123: 3122: 3085: 3079: 3078: 3047:J Clin Rheumatol 3042: 3005: 3004: 3002: 3000: 2952: 2946: 2945: 2935: 2903: 2894: 2893: 2857: 2840: 2839: 2824:Am Fam Physician 2819: 2798: 2797: 2795: 2793: 2774: 2765: 2764: 2754: 2722: 2716: 2715: 2713: 2711: 2692: 2686: 2685: 2675: 2673:10.7326/M16-0461 2651: 2640: 2639: 2637: 2635: 2616: 2610: 2609: 2573: 2546: 2545: 2535: 2503: 2497: 2496: 2457: 2451: 2450: 2448: 2446: 2437:. Archived from 2427: 2421: 2420: 2410: 2408:10.7326/m16-0570 2386: 2380: 2379: 2343: 2270: 2269: 2241: 2224: 2223: 2195: 2182: 2181: 2171: 2147: 2128: 2127: 2088: 2045: 2044: 2042: 2040: 2012: 2006: 2005: 2003: 2001: 1973: 1874:Dutch scientist 1858:; if the hands, 1773: 1770: 1741: 1661: 1649: 1637: 1625: 1613: 1601: 1585: 1566:Achilles tendons 1477:, among others. 1455:COX-2 inhibitors 1363: 1355: 1191: 1175: 1159: 1143: 1100:septic arthritis 937:Septic arthritis 849: 841: 649:hemolytic anemia 397:and high fever. 252: 247: 246: 243: 242: 239: 236: 82:). Leading with 73: 72: 42: 21: 8104: 8103: 8099: 8098: 8097: 8095: 8094: 8093: 8039: 8038: 8037: 8032: 8016:Heberden's node 7999:Noninflammatory 7990: 7945: 7917: 7884: 7855: 7823: 7819:Joint stiffness 7802: 7771: 7766: 7725: 7705: 7695: 7676: 7668: 7660: 7655: 7654: 7574: 7573: 7494: 7480: 7475: 7474: 7443:(9): CD009993. 7430: 7429: 7425: 7415: 7413: 7399: 7398: 7394: 7384: 7382: 7330: 7329: 7325: 7287: 7286: 7282: 7244: 7243: 7236: 7200: 7199: 7195: 7185: 7183: 7168: 7167: 7163: 7146: 7145: 7141: 7134: 7121: 7120: 7116: 7106: 7104: 7090: 7089: 7085: 7075: 7073: 7060: 7059: 7055: 7045: 7041: 7021: 7020: 7016: 7006: 7004: 6991: 6990: 6986: 6973: 6971: 6964: 6949: 6948: 6944: 6914: 6913: 6902: 6873:(11): 649–662. 6864: 6863: 6859: 6829: 6828: 6824: 6780: 6779: 6775: 6765: 6763: 6753: 6752: 6748: 6704: 6703: 6699: 6663: 6662: 6658: 6636: 6635: 6628: 6597:(9): CD009993. 6584: 6583: 6574: 6564: 6562: 6513:(2): CD005521. 6502: 6497: 6496: 6492: 6463:(4): CD009920. 6458: 6457: 6453: 6443: 6441: 6437: 6396: 6391: 6390: 6386: 6355:(8): CD006190. 6342: 6341: 6337: 6320: 6319: 6312: 6302: 6300: 6271: 6270: 6263: 6253: 6251: 6199: 6198: 6191: 6139: 6138: 6131: 6101: 6100: 6096: 6063:(Suppl 1): S3. 6050: 6049: 6045: 6023: 6022: 6015: 5961: 5960: 5956: 5946: 5944: 5940: 5901: 5896: 5895: 5891: 5847: 5846: 5839: 5802:Ann. Rheum. Dis 5795: 5794: 5787: 5777: 5775: 5771: 5764: 5760: 5759: 5755: 5745: 5743: 5734: 5733: 5729: 5719: 5717: 5708: 5707: 5700: 5686: 5685: 5681: 5671: 5669: 5656: 5655: 5651: 5612:(3): CD008335. 5599: 5598: 5594: 5563:(8): CD010069. 5550: 5549: 5545: 5499: 5498: 5494: 5477: 5476: 5469: 5429: 5428: 5424: 5414: 5412: 5378: 5377: 5373: 5356: 5349: 5347: 5340:"Archived copy" 5338: 5337: 5333: 5323: 5321: 5314: 5299: 5298: 5291: 5239: 5238: 5234: 5182: 5181: 5177: 5167: 5165: 5152: 5151: 5147: 5137: 5135: 5128:www.nice.org.uk 5122: 5121: 5117: 5108: 5106: 5084: 5083: 5079: 5057: 5056: 5052: 5039:(11): 369–371. 5030: 5029: 5025: 5015: 5013: 4969: 4968: 4964: 4928: 4927: 4923: 4875: 4874: 4870: 4832: 4831: 4820: 4798: 4797: 4793: 4747: 4746: 4739: 4703: 4702: 4698: 4654: 4653: 4649: 4618:(10): e013191. 4605: 4604: 4600: 4589: 4587: 4574:Rothschild BM. 4573: 4572: 4568: 4524: 4523: 4519: 4489: 4488: 4484: 4467: 4466: 4462: 4445: 4444: 4440: 4427:(11): 353–355. 4418: 4417: 4413: 4367: 4366: 4362: 4340: 4339: 4335: 4299: 4298: 4294: 4284: 4282: 4265: 4264: 4260: 4253: 4238: 4237: 4233: 4189: 4188: 4184: 4174: 4172: 4159: 4158: 4151: 4129: 4128: 4124: 4102: 4101: 4097: 4079: 4078: 4074: 4038: 4037: 4028: 4018: 4016: 3971:Chen Y (2020). 3970: 3969: 3965: 3958: 3945: 3944: 3940: 3904: 3903: 3894: 3861:10.2307/3433873 3842: 3841: 3837: 3799: 3798: 3794: 3763:(10): 610–621. 3750: 3749: 3742: 3708: 3707: 3703: 3651: 3650: 3646: 3616: 3615: 3611: 3573: 3572: 3565: 3520: 3519: 3515: 3477: 3476: 3472: 3433:(5): CD010039. 3420: 3419: 3415: 3377: 3376: 3372: 3326: 3325: 3316: 3279: 3278: 3271: 3233: 3232: 3223: 3175: 3174: 3167: 3131: 3130: 3126: 3087: 3086: 3082: 3044: 3043: 3008: 2998: 2996: 2954: 2953: 2949: 2905: 2904: 2897: 2859: 2858: 2843: 2821: 2820: 2801: 2791: 2789: 2776: 2775: 2768: 2724: 2723: 2719: 2709: 2707: 2694: 2693: 2689: 2653: 2652: 2643: 2633: 2631: 2618: 2617: 2613: 2575: 2574: 2549: 2505: 2504: 2500: 2459: 2458: 2454: 2444: 2442: 2429: 2428: 2424: 2388: 2387: 2383: 2345: 2344: 2273: 2243: 2242: 2227: 2197: 2196: 2185: 2149: 2148: 2131: 2090: 2089: 2048: 2038: 2036: 2029: 2014: 2013: 2009: 1999: 1997: 1990: 1975: 1974: 1970: 1965: 1953: 1943:response. Less 1914: 1888: 1835:Thomas Sydenham 1771: 1723: 1675: 1668: 1665:Gross pathology 1662: 1653: 1650: 1641: 1638: 1629: 1626: 1617: 1614: 1605: 1602: 1593: 1586: 1527: 1522: 1502: 1494:joint infection 1486:Glucocorticoids 1483: 1481:Glucocorticoids 1463: 1426: 1402:glucocorticoids 1389: 1377:kidney problems 1361: 1353: 1285:to six months. 1258: 1206: 1199: 1192: 1183: 1176: 1167: 1160: 1151: 1144: 1092: 1080:kidney function 1060: 1048:polarized light 1028: 1007:rheumatic fever 836: 732: 730:Pathophysiology 677: 669:body mass index 613: 551: 505:physical trauma 477: 471:4.5% per year. 456:crystallization 436: 422:, resulting in 363: 331:glucocorticoids 325:Treatment with 255:) is a form of 250: 233: 229: 206:glucocorticoids 168:Joint infection 78:Video summary ( 62: 40: 35: 28: 23: 22: 15: 12: 11: 5: 8102: 8100: 8092: 8091: 8086: 8081: 8076: 8071: 8066: 8061: 8056: 8051: 8041: 8040: 8034: 8033: 8031: 8030: 8029: 8028: 8023: 8018: 8011:Osteoarthritis 8008: 8002: 8000: 7996: 7995: 7992: 7991: 7989: 7988: 7983: 7978: 7977: 7976: 7966: 7965: 7964: 7953: 7951: 7947: 7946: 7944: 7943: 7938: 7933: 7927: 7925: 7919: 7918: 7916: 7915: 7910: 7905: 7900: 7894: 7892: 7886: 7885: 7883: 7882: 7877: 7871: 7865: 7863: 7857: 7856: 7854: 7853: 7848: 7842: 7840: 7831: 7825: 7824: 7822: 7821: 7816: 7810: 7808: 7804: 7803: 7801: 7800: 7795: 7793:Oligoarthritis 7790: 7785: 7779: 7777: 7773: 7772: 7767: 7765: 7764: 7757: 7750: 7742: 7736: 7735: 7723: 7709:, ed. (1911). 7703: 7679: 7662: 7661: 7657: 7656: 7653: 7652: 7643: 7632: 7621: 7595: 7583: 7582: 7580: 7576: 7575: 7572: 7571: 7560: 7549: 7535: 7511: 7495: 7490: 7489: 7487: 7486:Classification 7479: 7478:External links 7476: 7473: 7472: 7423: 7412:on 20 May 2010 7392: 7323: 7296:(7): 499–516. 7280: 7253:(3): 234–239. 7234: 7193: 7161: 7139: 7132: 7114: 7083: 7053: 7039: 7014: 6984: 6962: 6942: 6927:(3): 215–221. 6900: 6857: 6838:(3): 228–234. 6822: 6793:(5): 266–270. 6773: 6746: 6697: 6656: 6626: 6572: 6490: 6451: 6407:(5): 670–677. 6384: 6335: 6310: 6261: 6189: 6129: 6094: 6070:10.1186/ar1908 6043: 6013: 5954: 5912:(1): 128–136. 5889: 5837: 5785: 5753: 5727: 5698: 5679: 5649: 5592: 5543: 5512:(7): 711–720. 5492: 5467: 5422: 5391:(2): 111–118. 5371: 5331: 5312: 5289: 5232: 5175: 5145: 5115: 5077: 5066:(5): 299–302. 5050: 5023: 4962: 4941:(7): 706–715. 4921: 4868: 4818: 4807:(2): 209–210. 4791: 4777:2027.42/155484 4760:(6): 879–895. 4737: 4696: 4647: 4598: 4566: 4517: 4498:(5): 403–404. 4482: 4460: 4438: 4421:Med Health R I 4411: 4360: 4349:(6): 759–767. 4333: 4292: 4258: 4251: 4231: 4182: 4149: 4138:(6): 424–431. 4122: 4111:(4): 849–850. 4095: 4072: 4051:(2): 383–386. 4026: 3963: 3956: 3938: 3892: 3855:(9): 928–938. 3835: 3792: 3740: 3701: 3664:(4): 372–377. 3644: 3625:(5): 580–586. 3609: 3582:(2): 165–172. 3563: 3513: 3486:(2): 179–186. 3470: 3413: 3370: 3341:(2): 192–202. 3314: 3269: 3221: 3165: 3144:(5): 709–721. 3124: 3080: 3006: 2973:10.1038/ng.106 2967:(4): 437–442. 2947: 2895: 2841: 2830:(6): 801–808. 2799: 2766: 2737:(2): 155–175. 2717: 2687: 2641: 2611: 2584:(2): 157–161. 2547: 2498: 2452: 2422: 2381: 2271: 2252:(1): ITC1-16. 2225: 2183: 2129: 2046: 2027: 2007: 1988: 1967: 1966: 1964: 1961: 1960: 1959: 1952: 1949: 1913: 1910: 1887: 1884: 1848:Thomas Marryat 1772: 1550 BC 1722: 1719: 1674: 1671: 1670: 1669: 1663: 1656: 1654: 1651: 1644: 1642: 1639: 1632: 1630: 1627: 1620: 1618: 1615: 1608: 1606: 1603: 1596: 1594: 1587: 1580: 1526: 1523: 1513:adverse events 1501: 1498: 1482: 1479: 1462: 1459: 1435:kidney failure 1425: 1422: 1388: 1385: 1257: 1254: 1234:dairy products 1212:from drinking 1205: 1202: 1201: 1200: 1193: 1186: 1184: 1177: 1170: 1168: 1161: 1154: 1152: 1145: 1138: 1110:(pseudogout), 1091: 1088: 1059: 1056: 1044:arthrocentesis 1036:synovial fluid 1027: 1026:Synovial fluid 1024: 1016:Synovial fluid 1010: 1009: 993:Inflammatory: 990: 989: 988:Cloudy yellow 986: 983: 980: 977: 971: 970: 969:Cloudy yellow 967: 964: 961: 958: 952: 951: 950:Cloudy yellow 948: 945: 942: 939: 933: 932: 931:Cloudy yellow 929: 926: 923: 920: 916: 915: 912: 909: 906: 903: 897: 896: 893: 890: 887: 884: 882:Osteoarthritis 878: 877: 874: 871: 868: 865: 861: 860: 857: 854: 851: 845: 835: 832: 787:interleukin 1β 731: 728: 696:ACE inhibitors 676: 673: 645:kidney failure 641:lead poisoning 612: 609: 550: 547: 476: 473: 435: 432: 362: 359: 221: 220: 217: 213: 212: 199: 195: 194: 184: 180: 179: 165: 159: 158: 152: 146: 145: 140: 136: 135: 128: 124: 123: 110: 104: 103: 98: 92: 91: 75: 74: 58: 57: 51: 47: 46: 38: 32:Podagra (moth) 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 8101: 8090: 8087: 8085: 8082: 8080: 8077: 8075: 8072: 8070: 8067: 8065: 8062: 8060: 8057: 8055: 8052: 8050: 8047: 8046: 8044: 8027: 8024: 8022: 8019: 8017: 8014: 8013: 8012: 8009: 8007: 8004: 8003: 8001: 7997: 7987: 7984: 7982: 7979: 7975: 7972: 7971: 7970: 7967: 7963: 7960: 7959: 7958: 7955: 7954: 7952: 7948: 7942: 7939: 7937: 7934: 7932: 7929: 7928: 7926: 7924: 7920: 7914: 7911: 7909: 7906: 7904: 7901: 7899: 7896: 7895: 7893: 7891: 7887: 7881: 7878: 7875: 7872: 7870: 7867: 7866: 7864: 7862: 7858: 7852: 7849: 7847: 7844: 7843: 7841: 7839: 7835: 7832: 7830: 7826: 7820: 7817: 7815: 7812: 7811: 7809: 7805: 7799: 7798:Polyarthritis 7796: 7794: 7791: 7789: 7788:Monoarthritis 7786: 7784: 7781: 7780: 7778: 7774: 7770: 7763: 7758: 7756: 7751: 7749: 7744: 7743: 7740: 7732: 7728: 7724: 7720: 7719: 7713: 7708: 7704: 7702: 7698: 7693: 7689: 7688: 7683: 7678: 7677: 7674: 7673: 7666: 7651: 7647: 7644: 7642: 7638: 7637: 7633: 7631: 7627: 7626: 7622: 7620: 7617: 7614: 7611: 7608: 7605: 7601: 7600: 7596: 7594: 7590: 7589: 7585: 7584: 7581: 7577: 7570: 7566: 7565: 7561: 7559: 7555: 7554: 7550: 7548: 7545: 7541: 7540: 7536: 7534: 7531: 7528: 7525: 7521: 7520: 7516: 7512: 7510: 7506: 7505: 7501: 7497: 7496: 7493: 7488: 7484: 7477: 7468: 7464: 7459: 7454: 7450: 7446: 7442: 7438: 7434: 7427: 7424: 7411: 7407: 7403: 7396: 7393: 7380: 7376: 7372: 7368: 7364: 7359: 7354: 7350: 7346: 7343:(6631): 357. 7342: 7338: 7334: 7327: 7324: 7319: 7315: 7311: 7307: 7303: 7299: 7295: 7291: 7284: 7281: 7276: 7272: 7268: 7264: 7260: 7256: 7252: 7248: 7241: 7239: 7235: 7230: 7226: 7221: 7216: 7212: 7208: 7204: 7197: 7194: 7181: 7177: 7176: 7171: 7165: 7162: 7157: 7153: 7149: 7143: 7140: 7135: 7129: 7125: 7118: 7115: 7102: 7098: 7094: 7093:"On Medicine" 7087: 7084: 7071: 7067: 7063: 7057: 7054: 7049: 7043: 7040: 7036: 7032: 7028: 7024: 7018: 7015: 7002: 6998: 6994: 6988: 6985: 6981: 6969: 6965: 6963:9780323995788 6959: 6955: 6954: 6946: 6943: 6938: 6934: 6930: 6926: 6922: 6918: 6911: 6909: 6907: 6905: 6901: 6896: 6892: 6888: 6884: 6880: 6876: 6872: 6868: 6861: 6858: 6853: 6849: 6845: 6841: 6837: 6833: 6826: 6823: 6818: 6814: 6809: 6804: 6800: 6796: 6792: 6788: 6784: 6777: 6774: 6761: 6757: 6750: 6747: 6742: 6738: 6733: 6728: 6724: 6720: 6716: 6712: 6708: 6701: 6698: 6693: 6689: 6684: 6679: 6675: 6671: 6667: 6660: 6657: 6652: 6648: 6644: 6640: 6633: 6631: 6627: 6622: 6618: 6613: 6608: 6604: 6600: 6596: 6592: 6588: 6581: 6579: 6577: 6573: 6560: 6556: 6552: 6547: 6542: 6538: 6534: 6529: 6524: 6520: 6516: 6512: 6508: 6501: 6494: 6491: 6486: 6482: 6478: 6474: 6470: 6466: 6462: 6455: 6452: 6436: 6432: 6428: 6423: 6418: 6414: 6410: 6406: 6402: 6395: 6388: 6385: 6380: 6376: 6371: 6366: 6362: 6358: 6354: 6350: 6346: 6339: 6336: 6331: 6327: 6323: 6317: 6315: 6311: 6298: 6294: 6290: 6286: 6282: 6278: 6277:NIHR Evidence 6274: 6268: 6266: 6262: 6249: 6245: 6241: 6236: 6231: 6227: 6223: 6219: 6215: 6211: 6207: 6203: 6196: 6194: 6190: 6185: 6181: 6176: 6171: 6167: 6163: 6159: 6155: 6151: 6147: 6143: 6136: 6134: 6130: 6125: 6121: 6117: 6113: 6109: 6105: 6098: 6095: 6090: 6086: 6081: 6076: 6071: 6066: 6062: 6058: 6054: 6047: 6044: 6039: 6035: 6031: 6027: 6020: 6018: 6014: 6009: 6005: 6000: 5995: 5991: 5987: 5982: 5977: 5973: 5969: 5965: 5958: 5955: 5939: 5935: 5931: 5927: 5923: 5919: 5915: 5911: 5907: 5900: 5893: 5890: 5885: 5881: 5876: 5871: 5867: 5863: 5859: 5855: 5851: 5844: 5842: 5838: 5833: 5829: 5824: 5819: 5815: 5811: 5807: 5803: 5799: 5792: 5790: 5786: 5770: 5763: 5757: 5754: 5741: 5737: 5731: 5728: 5715: 5711: 5705: 5703: 5699: 5694: 5690: 5683: 5680: 5667: 5663: 5659: 5653: 5650: 5645: 5641: 5636: 5631: 5627: 5623: 5619: 5615: 5611: 5607: 5603: 5596: 5593: 5588: 5584: 5579: 5574: 5570: 5566: 5562: 5558: 5554: 5547: 5544: 5539: 5535: 5530: 5525: 5520: 5515: 5511: 5507: 5503: 5496: 5493: 5488: 5484: 5480: 5474: 5472: 5468: 5463: 5459: 5454: 5449: 5445: 5441: 5437: 5433: 5426: 5423: 5410: 5406: 5402: 5398: 5394: 5390: 5386: 5382: 5375: 5372: 5367: 5361: 5345: 5341: 5335: 5332: 5319: 5315: 5309: 5305: 5304: 5296: 5294: 5290: 5285: 5281: 5276: 5271: 5267: 5263: 5259: 5255: 5251: 5247: 5243: 5236: 5233: 5228: 5224: 5219: 5214: 5210: 5206: 5202: 5198: 5194: 5190: 5186: 5179: 5176: 5163: 5159: 5155: 5149: 5146: 5133: 5129: 5125: 5119: 5116: 5104: 5100: 5096: 5092: 5088: 5081: 5078: 5073: 5069: 5065: 5061: 5054: 5051: 5046: 5042: 5038: 5034: 5027: 5024: 5011: 5007: 5003: 4999: 4995: 4990: 4985: 4981: 4977: 4973: 4966: 4963: 4958: 4954: 4949: 4944: 4940: 4936: 4932: 4925: 4922: 4917: 4913: 4908: 4903: 4899: 4895: 4891: 4887: 4883: 4879: 4872: 4869: 4864: 4860: 4856: 4852: 4848: 4844: 4840: 4836: 4829: 4827: 4825: 4823: 4819: 4814: 4810: 4806: 4802: 4795: 4792: 4787: 4783: 4778: 4773: 4768: 4763: 4759: 4755: 4751: 4744: 4742: 4738: 4733: 4729: 4724: 4719: 4715: 4711: 4707: 4700: 4697: 4692: 4688: 4683: 4678: 4674: 4670: 4666: 4662: 4658: 4651: 4648: 4643: 4639: 4634: 4629: 4625: 4621: 4617: 4613: 4609: 4602: 4599: 4585: 4581: 4577: 4570: 4567: 4562: 4558: 4553: 4548: 4544: 4540: 4536: 4532: 4528: 4521: 4518: 4513: 4509: 4505: 4501: 4497: 4493: 4486: 4483: 4478: 4474: 4470: 4464: 4461: 4456: 4452: 4448: 4442: 4439: 4434: 4430: 4426: 4422: 4415: 4412: 4407: 4403: 4398: 4393: 4389: 4385: 4381: 4377: 4376: 4371: 4364: 4361: 4356: 4352: 4348: 4344: 4337: 4334: 4329: 4325: 4320: 4315: 4311: 4307: 4303: 4296: 4293: 4281: 4277: 4273: 4269: 4262: 4259: 4254: 4248: 4244: 4243: 4235: 4232: 4227: 4223: 4218: 4213: 4209: 4205: 4201: 4197: 4193: 4186: 4183: 4170: 4166: 4162: 4156: 4154: 4150: 4145: 4141: 4137: 4133: 4126: 4123: 4118: 4114: 4110: 4106: 4099: 4096: 4091: 4087: 4083: 4076: 4073: 4068: 4064: 4059: 4054: 4050: 4046: 4042: 4035: 4033: 4031: 4027: 4014: 4010: 4006: 4001: 3996: 3991: 3986: 3982: 3978: 3974: 3967: 3964: 3959: 3953: 3949: 3942: 3939: 3934: 3930: 3925: 3920: 3916: 3912: 3908: 3901: 3899: 3897: 3893: 3888: 3884: 3879: 3874: 3870: 3866: 3862: 3858: 3854: 3850: 3846: 3839: 3836: 3831: 3827: 3823: 3819: 3815: 3811: 3807: 3803: 3796: 3793: 3788: 3784: 3779: 3774: 3770: 3766: 3762: 3758: 3754: 3747: 3745: 3741: 3736: 3732: 3728: 3724: 3720: 3716: 3712: 3709:Merriman TR, 3705: 3702: 3697: 3693: 3688: 3683: 3679: 3675: 3671: 3667: 3663: 3659: 3655: 3648: 3645: 3640: 3636: 3632: 3628: 3624: 3620: 3613: 3610: 3605: 3601: 3597: 3593: 3589: 3585: 3581: 3577: 3570: 3568: 3564: 3559: 3555: 3550: 3545: 3541: 3537: 3533: 3530: 3529: 3524: 3517: 3514: 3509: 3505: 3501: 3497: 3493: 3489: 3485: 3481: 3474: 3471: 3466: 3462: 3457: 3452: 3448: 3444: 3440: 3436: 3432: 3428: 3424: 3417: 3414: 3409: 3405: 3401: 3397: 3393: 3389: 3385: 3381: 3374: 3371: 3366: 3362: 3357: 3352: 3348: 3344: 3340: 3336: 3335: 3330: 3323: 3321: 3319: 3315: 3310: 3306: 3301: 3296: 3292: 3289: 3288: 3283: 3276: 3274: 3270: 3265: 3261: 3257: 3253: 3249: 3245: 3241: 3237: 3230: 3228: 3226: 3222: 3217: 3213: 3208: 3203: 3199: 3195: 3191: 3187: 3183: 3179: 3172: 3170: 3166: 3161: 3157: 3152: 3147: 3143: 3139: 3135: 3128: 3125: 3120: 3116: 3112: 3108: 3104: 3100: 3096: 3092: 3084: 3081: 3076: 3072: 3068: 3064: 3060: 3056: 3052: 3048: 3041: 3039: 3037: 3035: 3033: 3031: 3029: 3027: 3025: 3023: 3021: 3019: 3017: 3015: 3013: 3011: 3007: 2994: 2990: 2986: 2982: 2978: 2974: 2970: 2966: 2962: 2958: 2951: 2948: 2943: 2939: 2934: 2929: 2925: 2921: 2917: 2913: 2909: 2902: 2900: 2896: 2891: 2887: 2883: 2879: 2875: 2871: 2867: 2863: 2856: 2854: 2852: 2850: 2848: 2846: 2842: 2837: 2833: 2829: 2825: 2818: 2816: 2814: 2812: 2810: 2808: 2806: 2804: 2800: 2787: 2783: 2779: 2773: 2771: 2767: 2762: 2758: 2753: 2748: 2744: 2740: 2736: 2732: 2728: 2721: 2718: 2705: 2702:. June 2015. 2701: 2697: 2691: 2688: 2683: 2679: 2674: 2669: 2665: 2661: 2657: 2650: 2648: 2646: 2642: 2629: 2625: 2621: 2615: 2612: 2607: 2603: 2599: 2595: 2591: 2587: 2583: 2579: 2572: 2570: 2568: 2566: 2564: 2562: 2560: 2558: 2556: 2554: 2552: 2548: 2543: 2539: 2534: 2529: 2525: 2521: 2517: 2513: 2509: 2502: 2499: 2494: 2490: 2486: 2482: 2478: 2474: 2470: 2466: 2462: 2456: 2453: 2440: 2436: 2432: 2426: 2423: 2418: 2414: 2409: 2404: 2400: 2396: 2392: 2385: 2382: 2377: 2373: 2369: 2365: 2361: 2357: 2353: 2349: 2342: 2340: 2338: 2336: 2334: 2332: 2330: 2328: 2326: 2324: 2322: 2320: 2318: 2316: 2314: 2312: 2310: 2308: 2306: 2304: 2302: 2300: 2298: 2296: 2294: 2292: 2290: 2288: 2286: 2284: 2282: 2280: 2278: 2276: 2272: 2267: 2263: 2259: 2255: 2251: 2247: 2240: 2238: 2236: 2234: 2232: 2230: 2226: 2221: 2217: 2213: 2209: 2205: 2201: 2194: 2192: 2190: 2188: 2184: 2179: 2175: 2170: 2165: 2162:(7): e1–e20. 2161: 2157: 2153: 2146: 2144: 2142: 2140: 2138: 2136: 2134: 2130: 2125: 2121: 2117: 2113: 2109: 2105: 2101: 2097: 2093: 2087: 2085: 2083: 2081: 2079: 2077: 2075: 2073: 2071: 2069: 2067: 2065: 2063: 2061: 2059: 2057: 2055: 2053: 2051: 2047: 2034: 2030: 2024: 2020: 2019: 2011: 2008: 1995: 1991: 1985: 1981: 1980: 1972: 1969: 1962: 1958: 1955: 1954: 1950: 1948: 1946: 1942: 1938: 1934: 1931: 1927: 1923: 1919: 1911: 1909: 1907: 1903: 1902: 1897: 1893: 1886:Other animals 1885: 1883: 1881: 1877: 1871: 1869: 1865: 1861: 1857: 1851: 1849: 1843: 1838: 1836: 1832: 1826: 1824: 1820: 1816: 1812: 1805: 1803: 1799: 1798:premenopausal 1795: 1791: 1790: 1785: 1781: 1777: 1766: 1762: 1761:Ebers papyrus 1757: 1755: 1751: 1747: 1746: 1740: 1731: 1727: 1720: 1718: 1714: 1712: 1708: 1704: 1700: 1696: 1692: 1691:United States 1687: 1685: 1680: 1679:Western world 1672: 1666: 1660: 1655: 1648: 1643: 1636: 1631: 1624: 1619: 1612: 1607: 1600: 1595: 1591: 1584: 1579: 1577: 1575: 1571: 1570:Kidney stones 1567: 1563: 1559: 1555: 1550: 1548: 1544: 1540: 1536: 1532: 1524: 1521: 1516: 1514: 1510: 1506: 1505:Interleukin-1 1499: 1497: 1495: 1491: 1487: 1480: 1478: 1476: 1472: 1467: 1460: 1458: 1456: 1452: 1448: 1444: 1440: 1439:heart failure 1436: 1432: 1423: 1421: 1419: 1415: 1411: 1407: 1403: 1399: 1395: 1386: 1384: 1382: 1381:kidney stones 1378: 1373: 1369: 1367: 1359: 1352: 1347: 1343: 1341: 1340:kidney stones 1335: 1331: 1329: 1325: 1321: 1317: 1313: 1309: 1308: 1303: 1299: 1297: 1290: 1286: 1283: 1279: 1275: 1274:benzbromarone 1271: 1267: 1263: 1255: 1253: 1251: 1247: 1243: 1240:-rich foods, 1239: 1235: 1231: 1227: 1223: 1219: 1215: 1211: 1203: 1197: 1190: 1185: 1181: 1178:In contrast, 1174: 1169: 1165: 1164:birefringence 1158: 1153: 1149: 1142: 1137: 1135: 1133: 1129: 1125: 1121: 1117: 1113: 1109: 1105: 1101: 1097: 1089: 1087: 1085: 1081: 1077: 1073: 1069: 1064: 1063:Hyperuricemia 1057: 1055: 1053: 1052:birefringence 1049: 1045: 1041: 1037: 1033: 1025: 1023: 1021: 1017: 1008: 1004: 1000: 996: 991: 987: 984: 981: 978: 976: 973: 972: 968: 965: 962: 959: 957: 954: 953: 949: 946: 943: 940: 938: 935: 934: 930: 927: 924: 921: 918: 917: 913: 910: 907: 904: 902: 899: 898: 895:Clear yellow 894: 891: 888: 885: 883: 880: 879: 875: 872: 869: 866: 863: 862: 858: 855: 853:% neutrophils 852: 846: 843: 842: 833: 831: 829: 825: 821: 817: 813: 808: 804: 798: 796: 792: 791:urate oxidase 788: 784: 780: 777: 773: 769: 765: 760: 756: 755:precipitating 752: 748: 741: 736: 729: 727: 724: 720: 717: 713: 709: 705: 704:beta blockers 701: 697: 693: 689: 685: 681: 674: 672: 670: 666: 662: 658: 654: 650: 646: 642: 638: 634: 630: 626: 622: 618: 610: 608: 606: 602: 598: 594: 590: 586: 582: 578: 574: 573: 568: 567: 562: 561: 556: 548: 546: 543: 541: 535: 533: 529: 525: 521: 517: 513: 508: 507:and surgery. 506: 502: 498: 494: 490: 486: 482: 474: 472: 469: 468:hyperuricemia 465: 461: 457: 449: 445: 440: 433: 431: 429: 425: 421: 417: 413: 412: 407: 406:hyperuricemia 403: 398: 396: 391: 387: 383: 376: 372: 367: 360: 358: 356: 350: 348: 344: 340: 336: 332: 328: 323: 321: 317: 313: 309: 305: 304:hyperuricemia 301: 296: 294: 293:kidney damage 290: 289:kidney stones 286: 282: 279:is affected ( 278: 274: 270: 266: 262: 261:swollen joint 258: 254: 253: 245: 227: 218: 214: 211: 207: 203: 200: 196: 193: 189: 186:Weight loss, 185: 181: 177: 173: 169: 166: 164: 160: 157: 153: 151: 147: 144: 141: 137: 133: 129: 125: 122: 118: 114: 111: 109: 105: 102: 99: 97: 93: 89: 88:James Gillray 85: 81: 76: 59: 56: 52: 48: 43: 37: 33: 19: 8069:Rheumatology 8006:Hemarthrosis 7890:Seronegative 7879: 7876:(Pseudogout) 7829:Inflammatory 7730: 7716: 7712:"Gout" 7685: 7670: 7645: 7634: 7623: 7616:orthoped/124 7597: 7586: 7562: 7551: 7537: 7513: 7498: 7440: 7436: 7426: 7414:. Retrieved 7410:the original 7405: 7395: 7385:29 September 7383:. Retrieved 7340: 7336: 7326: 7293: 7289: 7283: 7250: 7246: 7210: 7207:Rheumatology 7206: 7196: 7184:. Retrieved 7174: 7164: 7151: 7142: 7123: 7117: 7105:. Retrieved 7096: 7086: 7074:. Retrieved 7065: 7056: 7042: 7034: 7026: 7017: 7007:18 September 7005:. Retrieved 6996: 6987: 6979: 6972:. Retrieved 6952: 6945: 6937:the original 6924: 6920: 6870: 6866: 6860: 6835: 6831: 6825: 6790: 6786: 6776: 6764:. Retrieved 6760:the original 6749: 6714: 6710: 6700: 6673: 6670:Rheumatology 6669: 6659: 6642: 6638: 6594: 6590: 6565:24 September 6563:. Retrieved 6510: 6506: 6493: 6460: 6454: 6442:. Retrieved 6404: 6400: 6387: 6352: 6348: 6338: 6301:. Retrieved 6276: 6252:. Retrieved 6209: 6205: 6149: 6145: 6107: 6103: 6097: 6060: 6056: 6046: 6032:(7): E1–E4. 6029: 6025: 5971: 5967: 5957: 5945:. Retrieved 5909: 5905: 5892: 5857: 5853: 5805: 5801: 5776:. Retrieved 5756: 5744:. Retrieved 5730: 5718:. Retrieved 5692: 5688: 5682: 5670:. 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