Early-Onset Gouty Arthritis

Abstract

Five cases of early-onset gouty arthritis are presented, with roentgenographic abnormalities evident in the first two decades of life. Three patients suffered from "primary" gout; classification of the other two patients was difficlut because of associated mental retardation, hypothyroidism and psoriasis. Radiographic alterations included soft-tissue masses and calcification, with typical erosive abnormalities and predilection for the hands and feet. The sacroiliac joints were abnormal in two patients.

Acute Gout of the Right Sacroiliac Joint

“…A review of the English language literature reveals 3 additional cases of idiopathic sacroiliac gout (8,11), two bilateral (11) and one limited to the left side of the sacroiliac joint (8).…”

“…The statistical results emerging from these investigations (3,4), disclose: a) of 24 patients with sacroiliac gout in one study (3), 15 had bilateral changes, 7 had unilateral involvement of the left sacroiliac joint, while only 2 had an affected right sacroiliac joint; b) of 10 patients with sacroiliac gout in the other study (4), 4 had bilateral changes, 4 presented left sacroiliac alterations, but the right side of the sacroiliac joint was only affected twice. A review of the English language literature reveals 3 additional cases of idiopathic sacroiliac gout (8,11), two bilateral (11) and one limited to the left side of the sacroiliac joint (8).…”

“…Hyperuricemia is the well known and characteristic laboratory finding associated with gout (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Radiological changes may also support the diagnosis (1)(2)(3)(4); however, according to several authors (1,2,6), the diagnosis of gout, particularly in its acute stage, does not depend on Roentgenographic alterations, because the results of the radiological examinations are mostly non-diagnostic, even in patients with recurrent attacks of acute gouty arthritis 0, 7).…”

Die quantitative Entwicklung von fibroostitischen im Vergleich zu synovitischen Reaktionen am Fingerskelett bei chronischer Polyarthritis*

“…Trotz der gleichen Häufigkeit von Artikulo-und Tenosynovitiden im Frühstadium der chronischen Polyarthritis (5) und trotz der auch langdauernden Tenosynovitiden entwickeln sich nur selten tenosynovitische Erosionen, und zwar nicht nur an der resistenten diaphysären Kompakta, sondern auch an dem dünnen und zum Teil nur spongiösen vololateralen Anbau am Ansatz der Pars anularis der Vagina fibrosa, an dem sich tenosynovitisch bedingte Demineralisationen jedoch erheblich auswirken können mit zum Teillangbestehender Konturauslöschung durch Entkalkung. Bei einer randständigen bogenförmigen diaphysären Destruktion ist auch an einen Gichttophus als Ursache zu denken (11,13).…”