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2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout
P. Richette, M. Doherty, E. Pascual, V. Barskova, F. Becce, J. Castaneda, M. Coyfish, S. Guillo, T. Jansen, H. Janssens, F. Lioté, CD. Mallen, G. Nuki, F. Perez-Ruiz, J. Pimentao, L. Punzi, A. Pywell, AK. So, AK. Tausche, T. Uhlig, J. Zavada, W....
Language English Country Great Britain
Document type Consensus Development Conference, Journal Article, Practice Guideline
NLK
ProQuest Central
from 1939-01-01 to 6 months ago
Health & Medicine (ProQuest)
from 1939-01-01 to 6 months ago
Family Health Database (ProQuest)
from 1939-01-01 to 6 months ago
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- Gout diagnosis diagnostic imaging epidemiology pathology MeSH
- Hyperuricemia diagnosis epidemiology MeSH
- Uric Acid MeSH
- Humans MeSH
- Tomography, X-Ray Computed MeSH
- Radiography MeSH
- Risk Factors MeSH
- Synovial Fluid MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Consensus Development Conference MeSH
- Practice Guideline MeSH
Although gout is the most common inflammatory arthritis, it is still frequently misdiagnosed. New data on imaging and clinical diagnosis have become available since the first EULAR recommendations for the diagnosis of gout in 2006. This prompted a systematic review and update of the 2006 recommendations. A systematic review of the literature concerning all aspects of gout diagnosis was performed. Recommendations were formulated using a Delphi consensus approach. Eight key recommendations were generated. A search for crystals in synovial fluid or tophus aspirates is recommended in every person with suspected gout, because demonstration of monosodium urate (MSU) crystals allows a definite diagnosis of gout. There was consensus that a number of suggestive clinical features support a clinical diagnosis of gout. These are monoarticular involvement of a foot or ankle joint (especially the first metatarsophalangeal joint); previous episodes of similar acute arthritis; rapid onset of severe pain and swelling; erythema; male gender and associated cardiovascular diseases and hyperuricaemia. When crystal identification is not possible, it is recommended that any atypical presentation should be investigated by imaging, in particular with ultrasound to seek features suggestive of MSU crystal deposition (double contour sign and tophi). There was consensus that a diagnosis of gout should not be based on the presence of hyperuricaemia alone. There was also a strong recommendation that all people with gout should be systematically assessed for presence of associated comorbidities and risk factors for cardiovascular disease, as well as for risk factors for chronic hyperuricaemia. Eight updated, evidence-based, expert consensus recommendations for the diagnosis of gout are proposed.
Academic Rheumatology Nottingham University Nottingham UK
Academic Rheumatology University of Nottingham Nottingham UK
Arthritis Research UK Primary Care Centre Keele University Keele UK
Biostatistics and epidemiology APHP Hopital Pitié Salpetrière Paris France
Centre Molecular Medicine University of Edinburgh Edinburgh Scotland UK
Département d'Epidémiologie et Recherche Clinique Paris France
Department of Medicine University of Padua Padua Italy
Institute of Rheumatology Prague Czech Republic Czech Republic
Institute of Rheumatology RAMS Moscow Russian
Musculoskeletal Medicine Service de RMR Lausanne Switzerland
Radiology Lausanne University Hospital Lausanne Switzerland
Rheumatology Assistance Publique Hopitaux de Paris Paris France
Rheumatology Diakonhjemmet Hospital Oslo Norway
Rheumatology Hospital General Universitario de Alicante Alicante Spain
Rheumatology Unit Clínica Coração de Jesus Lisbon Portugal
References provided by Crossref.org
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