Chronic Tophaceous Gout Treated Mistakenly as Rheumatoid Arthritis for One Year
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Firat University, Faculty of Medicine, Elazıg, Turkey
Elazıg Training and Research Hospital of the Ministry of Health, Elazıg, Turkey
Publication date: 2012-04-10
Corresponding author
Hasan Ulusoy   

Firat Universitesi, Tip Fakultesi, Fiziksel Tip ve Rehabilitasyon AD, Romatoloji BD 23119 Elazig, Turkey
Eur J Gen Med 2012;9(2):155-158
Gout is a common disorder characterized by hyperuricemia and the deposition of monosodium urate crystals in various tissues. Clinical manifestations of gout include attacks of acute inflammatory arthritis, a chronic destructive arthropathy known as chronic tophaceous gout, and non-articular accumulation of monosodium urate crystals crystals suchs as tophi and kidney stones. Acute gouty arthritis usually begins with one joint in the lower limbs, such as first metatarsophalangeal joint, midtarsi, ankles and knees. Subsequent attacks frequently last longer than does the first attack, affect several joints, and are prone to spread to the upper limbs, especially to small joints of the hands. Although acute gouty arthritis is familiar for most physicians chronic gouty arthritis which affects small joints of the hands can be difficult to distinguish from other common interphalangeal arthropathies such as rheumatoid arthritis, psoriatic arthritis and erosive osteoarthritis. Because of very similar presentations, an awareness of the differential diagnosis, as well as a combination of clinical, radiographic, and laboratory findings is necessary to differentiate these diseases. Here we describe a case of chronic tophaceous gout who had been treated mistakenly as rheumatoid arthritis for one year.
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