An 82-year-old man with hypertension and gout developed periods of dizziness, neck pain, and arm weakness. Could the gout be responsible?

An international panel of rheumatologists issues new recommendations for the diagnosis and management of gout -- hoping to improve often uneven and suboptimal patient care that exists despite numerous care guidelines and new therapies.

A small exploratory study suggests that intensively lowering urate levels in tophaceous gout improves structural damage seen on radiography, particularly bone erosion.

New this week in the nonspecialty journals: Tattoos and sarcoidosis, oral ulcers and autoimmunity, gout and heart disease, and a review about a gene that affects autoimmune inflammation.

The interleukin-1 inhibitor dampened the bouts of pain by more than 70% for gout patients as they begin urate-lowering treatment in the international PRESURGE-2 trial.

They may be supported by guidelines and commonly used in practice, but joint injections with glucocorticoids for acute gout are not backed by any randomized controlled clinical trials, according to a new Cochrane report. However, the report backs away from saying they should not be used.

A series of studies using functional MRI have identified brain-signal patterns specific for pain that are attenuated by opioids: Also last week: top rheumatology findings of 2012, more on TNF inhibitors and cancer, and concerns about vitamin D.


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