[Uncharacteristic symptoms of the motor apparatus in gout]

Gout may present in such atypical forms as "primary-chronic", "masked", or "asymptomatic gout at all stages affecting almost any joint. These uncharacteristic presentations were found in 22 out of 124 patients observed. The disease of 4 patients is described as casuistics. Important conclusions of practical use for early diagnosis and early treatment are drawn. Every arthropathy in a male where the diagnosis is not certain, must be suspected as being due to gout. The diagnosis can be assured by detecting urate deposits in the tissue. Determinations of the serum uric acid level can only be indicative since they are subject to a variety of influences. In early disease the x-ray appearances may be described as normal; in later disease as "degenerative" in the joints or in the vertebral column. In an acute relapse the colchicine-test is of high specifity, but its interpretation may be difficult in the primary chronic forms. The other clinical manifestations of the gout syndrome are of high value for the selection of patients in whom urate deposits in the tissue must be sought.