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Gout: a comprehensive review

Eric Rymal1, Denise Rizzolo

  • 1Eric Rymal practices physical medicine in Hampton Roads, Va., managing acute and chronic musculoskeletal conditions. Denise Rizzolo is an associate professor in the PA program at Seton Hall University in South Orange, N.J., an assistant clinical professor in the PA program at Pace University in New York City, and practices urgent care in Springfield, N.J.The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|August 8, 2014
PubMed

Insights

Gout prevalence is rising, linked to genetic factors affecting uric acid. Diagnosis uses joint fluid analysis, imaging, and newer treatments are available for difficult cases.

Area of Science:

  • Rheumatology
  • Genetics
  • Metabolic Disorders

Background:

  • Increasing prevalence of gout in the United States population.
  • Association of genetic variants with abnormal uric acid metabolism.
  • Gout comorbidities include obesity and cardiovascular disease.

Purpose of the Study:

  • To summarize current understanding of gout diagnosis and management.
  • To highlight genetic predispositions to gout.
  • To discuss advanced therapeutic options.

Main Methods:

  • Review of genome-wide association studies for gout-related DNA variants.
  • Analysis of diagnostic methods including arthrocentesis, CT, and ultrasound.
  • Evaluation of immunologic agents for refractory gout.

Main Results:

  • Identification of multiple DNA sequence variants linked to gout.
  • Established role of imaging in supplementing diagnosis and monitoring.
  • Availability of novel immunologic therapies for treatment-resistant cases.

Conclusions:

  • Gout is a growing concern with a genetic component affecting uric acid levels.
  • Comprehensive diagnostic approaches combine fluid analysis with imaging.
  • Emerging immunotherapies offer new hope for refractory gout patients.

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