• Hip & pelvis
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• v.36 no.1
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• pp.1-11
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• 2024

Gout is triggered by the accumulation of uric acid in the body, leading to hyperuricemia. Genetic, metabolic, and environmental factors can influence this condition. Excessive uric acid buildup results in the formation of monosodium urate (MSU) crystals, which precipitate in specific areas of the body, including the joints, where they can cause symptoms of gout. While the acute and chronic symptoms of gout have been well-documented, diagnosis of gout affecting the hip joint poses significant challenges. The global incidence of gout, the most prevalent form of inflammatory arthritis, is on the rise. Evaluation of the clinical signs, laboratory results, and imaging results is generally required for diagnosis of gout in cases where MSU crystals have not been detected. Hyperuricemia is considered a primary cause of arthritis symptoms, and comprehensive guidelines for treatment are available. Therefore, the choice of medication is straightforward, and moderate effectiveness of treatment has been demonstrated. Gout is a chronic disease, requiring lifelong uric acid-lowering medications, thus application of a treatment strategy based on the target blood uric acid concentration is necessary. Consequently, cases of gout will likely be observed more frequently by hip surgeons in clinical scenarios in the future. The objective of this review is to provide an overview of the pathophysiology of gout and subsequently examine recent advances in diagnostic methods and therapeutic agents based on an understanding of its underlying mechanisms. In addition, literature on gout-related issues affecting the hip joint, providing a useful reference for hip surgeons is examined.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.189-193
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• 2018

Gouty arthritis is a common crystal arthropathy, but gout tophus in the bipartite patella is a rare condition. This report presented a traumatic separation of bipartite patellar fragment caused by mild trauma in a patient with comorbid gout. When a patient with bipartite patella and underlying gouty arthritis complains of pain after trauma, clinical suspicion is needed about fragment separation of the bipartite patella.

• Journal of Korean Foot and Ankle Society
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• v.16 no.4
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• pp.280-285
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• 2012

Osteochondroma, which is an osteocartilaginous exostosis, is essentially the most common primary bone tumor. These benign neoplasms are generally asymptomatic and have a relatively small potential for adverse effects. Calcaneal osteochondroma is rare, furthermore osteochondroma accompanying with gouty arthritis is very rare. Also, the subtalar joint is not a classic site of acute gout. In this report, we report the case of a patient who experienced an unusual calcaneal osteochondroma with undiagnosed gouty arthritis of the subtalar joint.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2001.11a
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• pp.7-13
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• 2001

Arthritis may be broadly classified as degenerative - related to defects in cartilage and other joint constituents, often age-associated - or inflammatory disease. Inflammatory arthritis called as rheumatoid arthritis (RA) is a chronic inflammatory arthropathy and characterized by a destructive arthritis. RA encompasses infectious arthritis, arthritis caused by intra-articular deposits of crystalline material (gout), syndromes associated with genetic defects (familial Mediterranean fever), and the immune-mediated inflammatory arthropathy. Degenerative arthritis called as osteoarthritis (OA), which is most frequently occurring, causes degenerative figures of knee, waist and knuckle, and accompanies severe pain around the cartilage. Also, it may cause morning stiffness, gelling effect, tenderness, bone swelling, crepitus, and motion disorders.

• Journal of Korean Foot and Ankle Society
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• v.22 no.3
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• pp.116-119
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• 2018

Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.

• Journal of Pharmacopuncture
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• v.25 no.4
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• pp.396-403
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• 2022

Objectives: Gout is an inflammatory arthritis of the joints and soft tissues occurring due to deposition of monosodium urate (MSU) crystals, which are caused by persistent hyperuricemia. Soyeom pharmacopuncture is one treatment method that has been traditionally used for pain management in Oriental medicine. However, studies on its effect in reducing gout pain have been insufficient. Therefore, we selected Soyeom pharmacopuncture among natural products used in Korea as the new target of our study. Methods: The effects of Soyeom pharmacopuncture were examined in mouse models of acute gout induced by injection of MSU crystals into footpads. IL-1β, IL-6, and TNF-α production were examined by immunoblotting and enzyme-linked immunosorbent assay as hallmarks of NLRP3 inflammasome and cytokine activation. Results: Soyeom pharmacopuncture reduced foot edema in gout-induced mice, as well as IL-1β, nitrite, IL-6, and TNF-α production. Moreover, Soyeom pharmacopuncture also reduced MSU-induced gout inflammatory gene expressions, specifically those in the NF-kB pathway. Conclusion: Pharmacopuncture may serve as a new solution for other inflammatory diseases as well. Through active follow-up studies, we could thoroughly understand the clinical value of Soyeom pharmacopuncture.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.92-109
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• 2022

Objectives: The objective of this study was to appraise the effect of electroacupuncture (EA) for the treatment of acute gout. Methods: Since no suitable study could be found in the domestic database, we performed a literature search up to the end of December 2020 using four international electronic databases. Randomized controlled trials (RCTs) evaluating the effectiveness of EA in the treatment of acute gout were included. The risk of bias was evaluated from the Cochrane risk of bias tool. Results: Eight appropriate RCTs were included and analyzed. Three evaluation tools were mainly used: Total Effective Rate (TER), Uric acid (UA), and Pain score (VAS). In the case of TER, in all eight cases, electroacupuncture alone and combined treatment showed a statistically significant level of improvement compared to Western medicine treatment. In the case of VAS score, electroacupuncture alone and combined treatment showed a more significant effect than Western medicine treatment. In the case of UA level, electroacupuncture combined treatment showed a more significant effect than western medicine treatment. Although not all three evaluation tools were used in all studies, the majority of studies showed that electroacupuncture was effective for acute gout patients. Conclusions: The results of this study suggest that EA treatment may be effective for acute gout. It should be noted, however, that the studies included in this study were geographically biased, small in number, and mostly at high risk of bias. More well-designed studies are needed in the future.

• The Journal of Korean Medicine
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• v.16 no.1 s.29
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• pp.9-20
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• 1995

I would like to state my own opinion on arthralgia syndrome(痺病) through the literatural studies. First of all, arthralgia symdrome(痺病) must be classified into six type basically, which are migratory arthralgia(痺病(行痺)), arthritis of heat type(濕痺), arthritis due to blood stasis(瘀血痺) and deficient rheumatism(虛痺), and then could be considered to try the compound names of arthralgia syndrome. These can come from according to the rise and decline of causes in wind(風), cold(寒), damp(濕), heat(熱), blood stasis(瘀血) and qi-blood(氣血). For example, it would be possible to apply the wind-dampness rheymatism(風濕痺) of damp-heat rheumatism(濕熱痺) in terminology of arthralgia syndrome(痺病). As rheumatoid arthritis(歷節風), rheumatoid arthritis like white tiger bite (白虎歷節風) and gout (痛風) not to mean the gout in western medicine have been announced a kind of arthralgia syndromes(痺病) by many doctors since Ming dynasty(明代) and proved it to be true, it is reasonabie not to try it any longer. And tingling and deficiency of sensation(廢木 不仁) is a symptome showing the decline of muscle power including mainly the abnormal sensation of skin, it would be recommended to be classified into fliaccidity syndrome(?痺). And then the names rheumatism invoiving lendon and ligament(筋痺), rheumatism involving blood vessels(脈痺), rheumatism involving muscle(肌痺), numbness of skin (皮痺) and rheumatism involving bone(骨痺), which have been used as the classification title with the season be received bad-qi(邪氣), must be classlfied to the location appearing aymptomes. Though obstruction of the liver-qi(肝痺), obstruction of the heart-qi(心痺), stagnation of the spleen-qi(脾痺), stagnation of the lung-qi(肺痺), stagnation of the kidney-qi(腎痺) and dysfunction of the bladder(胞痺) that used visceral and bladder name, that stated a kind of arthralgia syndrome(痺病), but it must be classified into a different diseases from arthragia syndrome.

• Journal of Acupuncture Research
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• v.40 no.4
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• pp.368-376
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• 2023

Background: Although bee venom (BV) has clinical benefits in osteoarthritis and rheumatoid arthritis, it has not been tested as treatment for gouty arthritis. Moreover, in vitro, BV has been proven to exhibit anti-inflammatory and positive effects on osteoarthritis, but only limited evidence can confirm its beneficial effects on gout. Thus, this study aims to assess the anti-inflammatory effects of BV on monosodium urate (MSU)-induced THP-1 monocytes. Methods: THP-1 monocytes were differentiated into mature macrophages using phorbol 12-myristate 13-acetate (PMA) and pretreated for 6 hours with BV and a Caspase-1 inhibitor in a physiologically achievable range of concentrations (BV, 0.1-1 ㎍/mL; Caspase-1 inhibitor, 1-10 μM), followed by MSU crystal stimulation for 24 hours. The secretions of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6, IL-8, cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and nitric oxide (NO) were increased in the MSU crystal-stimulated THP-1 cells. Results: Caspase-1 inhibitors suppressed the production of all mediators in a dose-dependent manner. BV worked on equal terms with Caspase-1 inhibitors and showed more satisfactory effects on TNF-α, PGE2, COX-2, and inducible nitric oxide synthase (iNOS). Moreover, the western blot analysis revealed that BV regulated the transcriptional levels of these mediators via the suppression of extracellular signal-regulated kinase (ERK) pathway activation. Conclusion: The results of the present study clearly suggest that BV inhibits MSU-induced inflammation in vitro, suggesting a possible role for BV in gout treatment.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.351-356
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• 2021

A 67-year-old male patient with a history of epididymectomy and anti-tuberculosis treatment for epididymis tuberculosis was admitted for acute low back pain and radiating pain. The patient had no history of gout but showed hyperuricemia and a bone destruction lesion in the facet joint and lamina of the lumbar spine. A histology examination was performed after a computed tomography-guided needle biopsy, and the findings were compatible with gout spondyloarthropathy and tuberculous spondylitis. The acute symptoms improved after conservative treatment for gouty arthritis. When patients with hyperuricemia risk factors, such as taking anti-tuberculosis drugs, complain of acute low back pain, gout spondyloarthropathy should be considered in a differential diagnosis.