Evaluation of patients with chronic gouty arthritis

Background: Chronic polyarticular presentation is not a common manifestation of gout and it may be confused especially with rheumatoid arthritis (RA). Objective: To evaluate the characteristics of patients with chronic polyarticular gout, important clues for differentiation from RA and its correlation with cardiovascular disease. Methods: 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. Findings: 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. Conclusion: It seems that chronic polyarticular gout is a kind of polyarthropathy that requires more attention to diagnosis.