Gouty arthritis in nodal osteoarthritis.
OBJECTIVE
To analyze the clinical features and identify factors associated with the development of gouty arthritis in nodal osteoarthritis (OA).


METHODS
Thirty-two consecutive patients (21 women and 11 men, mean age 75.8 years) with both nodal OA and crystal proven acute gout and/or tophi of distal/proximal interphalangeal (DIP/PIP) joints were studied between 1986 and 1994.


RESULTS
Tophi of DIP and/or PIP joints were present in 29 (90%) patients; alone in 9 and together with acute DIP or PIP gouty arthritis in 20. Three patients had acute DIP or PIP gouty episodes but no digital tophi. Mean pretreatment serum urate was 614.9 +/- 163.2 (range 422-1088 mumol/l). Risk factors for gout included diuretic use (81%), renal failure (59%), hypertension (66%), alcoholism (22%), prophylactic low dose ASA (20%), and a positive family history (16%) of patients.


CONCLUSIONS
The coexistence of gouty arthritis in nodal OA is important to recognize and treat, particularly in elderly women with renal failure, hypertension, or cardiac failure who are receiving longterm diuretic therapy.
Fam
A G
AG
Department of Medicine, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
Stein
J
J
Rubenstein
J
J
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D015210:Arthritis, Gouty / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D006074:Gout Suppressants; D000493:Allopurinol