Differential diagnosis of gouty arthritis (clinical cases)

Abstract

Joint syndrome affects patients of all ages. The peculiarity is that joint pain can occur in one person for various reasons, which requires differential diagnosis and subsequent prescription of the correct treatment. Often, pain is associated with gouty arthritis without differential diagnosis, and the level of uric acid is not always determined, or treatment is prescribed without further investigation in case of elevated levels of uric acid in the blood. It should be noted that elevated uric acid levels, even above 9 mg/dL, can lead to the development of gouty arthritis within five years [3]. A certain number of patients have atypical manifestations of gout, when pain occurs in the knee joints without manifestations in the foot joints. A feature of gouty arthritis is that in some cases, several joints may be affected simultaneously, or the joints of one limb may be affected rapidly in succession. In addition, sodium monourate crystals may be deposited in Heberden's and Bouchard's nodules, which also makes diagnosis difficult. Most often, differential diagnosis of gouty arthritis is carried out with chondrocalcinosis, psoriatic arthritis, septic or rheumatoid arthritis. However, these diseases are differentiated at initial diagnosis [1]. The aim of the study was to conduct a differential diagnosis of the clinically established diagnosis of gouty arthritis to exclude other causes of joint pain. Three clinical cases are described in which concomitant joint diseases were identified, which subsequently led to a significant improvement in the control of joint pain.