Evaluation of patients with chronic gouty arthritis

Chronic polyarticular presentation is not a common manifestation of gout and it may be confused especially with rheumatoid arthritis (RA). To evaluate the characteristics of patients with chronic polyarticular gout, important clues for differentiation from RA and its correlation with cardiovascular disease. This was a descriptive study on patients with chronic polyarticular gout who, for the first time, were admitted to Ghaem Hospital, Mashhad University of Medical Sciences during1998-2006. Diagnosis was based on international criteria of gout. Patients with arthritis in less than four joints were excluded from the study. Eighteen patients were enrolled. In 8 patients (44.4%), the joint involvements were similar to RA and in two patients crystals of calcium pyrophosphate in synovial fluid (12.5%) also found. One patient had a pseudotumor on the tophus, and two with Achill’s tendinitis. Among patients, 61% suffered from cardiovascular disease. In these patients 39% had chronic renal failure, 22.2% had diabetes, and 50% had hypertriglyceridemia. It seems that chronic polyarticular gout is a kind of polyarthropathy that requires more attention to diagnosis.