Gout may present in such atypical forms as "primary-chronic", "masked", or "asymptomatic gout at all stages affecting almost any joint. These uncharacteristic presentations were found in 22 out of 124 patients observed. The disease of 4 patients is described as casuistics. Important conclusions of practical use for early diagnosis and early treatment are drawn. Every arthropathy in a male where the diagnosis is not certain, must be suspected as being due to gout. The diagnosis can be assured by detecting urate deposits in the tissue. Determinations of the serum uric acid level can only be indicative since they are subject to a variety of influences. In early disease the x-ray appearances may be described as normal; in later disease as "degenerative" in the joints or in the vertebral column. In an acute relapse the colchicine-test is of high specifity, but its interpretation may be difficult in the primary chronic forms. The other clinical manifestations of the gout syndrome are of high value for the selection of patients in whom urate deposits in the tissue must be sought.

Adult↗

PubMedDate not supplied

[Reflection of local inflammatory activity in rheumatic diseases in synovial imprint cytology].

Cytological signs of the synovial imprint preparation have been correlated with findings of systemic, histomorphologic and arthroscopic inflammatory symptoms in 123 patients with rheumatic arthropathies. Out of the observed cellular and non-cellular structures of the synovial imprint cytology, fibrin, fibrinous necroses and relations of neutrophil polymorphs, as well as synovial phagocytes, reflect the acute inflammatory activity of the joint examined. The content in synovial imprint preparation of cells and cell groups are manners of expression both of the acute and proliferative activity as well as basic activity, respectively, of the synovial membrane. The synovial imprint cytogram's number of giant cells correlates with the histomorphologic degree of severity of the local proliferative inflammatory activity. Correlations between the level of the 1-h-value of the erythrocyte sedimentation rate (ESR) and the imprintocytological finding cellular distribution density, as well as relations between synoviocytes and neutrophil polymorphs, had to be demonstrated statistically. No correlations, however, were found between cytologic structures of inflammatory activities of the synovial imprint cytogram and the differential cell picture of the associated serosynovitis.

Arthritis, Infectious↗

PubMedDate not supplied

[In memory of Prof. Dr. med. Hans Alois Carl Tichy].

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Germany, East↗