Total joint fluid urate in gout.
BACKGROUND
Synovial fluid urates are traditionally measured as supernatants, and levels are reported to be comparable to serum levels.


OBJECTIVE
We have decided to attempt to define a more accurate parameter of gouty urate load in the joint fluid.


METHODS
In 23 gouty joints of various activity, the urate level was determined by both the traditional method and by heating and agitation to dissolve crystals yielding total joint fluid urate (TJFU).


RESULTS
TJFU was higher than the serum level or traditional urate level, and the gradient (TJFU-synovial fluid urate) was proportional to gouty activity.


CONCLUSIONS
We propose that TJFU is more representative of the pathophysiology of gout and deserves further evaluation of its implications.
Tiliakos
Athan N
AN
Department of Internal Medicine, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA.
Tiliakos
Nicholas A
NA