Atypical Gout Manifestations in General Practice–Family Medicine: Own Clinical Observations and Literature Data

The objective: to study and systematize own clinical observations and management of gout cases and atypical gout manifestations and literature data on this item. Clarification of main characteristics of atypical manifestations of this pathological condition. Scientific and practical base of the investigation was Kiev City Clinical Hospital № 8, which admits patients by the reference of primary care physicians in general practice – family medicine. Clinically gout is preferably a male disease. The condition is more often seen in men, than in women, but in women it is more obvious in postmenopausal period. Women with gout are more proun to have atypical manifestation (for example, disease on fingers and ankle joint), which becomes at atypical age, making efficiency of treatment problematic because of coexisting comorbidities. Gout is a common and exclusively painful form of inflammatory arthritis, which typically involves first metatarsophalangeal joint (and terminologically this is gout). Atypical signs of the gout are described now with increasing rate in definite populational groups, such as elder people, people with genetic predispositions, enzyme deficiencies, prosthetic implants and those receiving immunosuppressive therapy. Gout can mimic other conditions, such as septic arthritis, osrteoarthritis, rheumatoid arthritis, pseudogout (accumulation of calcium pyrophosphates) and even periarticular tumors. Gout can coexist with other arthropaties, making diagnosis more difficult. Article contains the description of authors own observations of patient with multiple gout atypical manifestations during 35 years. Lower extremities were not involved in the process for a long period of time, and only near 2,5-3 last years patient noted, that tophuses start to appear ass well on both legs. Atypical features differ from “classical” gout, which is found in men of middle age with different aspects: there is no prevalence of men, but there is more uniform gender distribution, polyarthicular involvement with upper extremity, less of acute gout episodes, not intensive clinical picture and increase rate of tophuses formation.