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Gout

Gout

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.

The RADAI joint index designed for rheumatoid arthritis patients provides equally powerful information about disease status in osteoarthritis and psoriatic arthritis, according to a new comparative study. As a guide to severity, it is much quicker than waiting for lab results to come in.

Despite hopes that rilonacept might provide a better alternative to NSAIDs or colchicines for gout pain, it does not provide significant relief either on its own or as an add-on therapy to indomethacin.

Does this evidence from recent research overturn some generally accepted principles about gout, rheumatoid arthritis, reactive arthritis, and osteoarthritis? Most of these studies were undertaken in order to test ideas that were described as common wisdom in rheumatology.

Dual-energy CT scans of ligaments and bones in patients with tophaceous gout showed patterns of monosodium urate crystal deposition suggestive of a role for biomechanical strain. The Achilles tendon was the most commonly involved site.

In an era characterized by an expanding array of expensive gout therapies, it may be that cherries have been overlooked.

Used for gout for centuries, colchicine is known to be peculiarly toxic at high doses. A new understanding of its potential for poisoning, deliberate or otherwise, merits attention to its often-underestimated risks.

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