Chronic Tophaceous Gout: Risk Factors For The Development of Tophi
What is gout?
Gouty arthritis by definition implies to a condition of joint inflammation due to the deposition of monosodium urat (MSU) crystal.1
Acute joint inflammation usually affecting the first metatarso-phalangeal joint referred to a very painful, redness and swollen joint that subsequently subsided within 5 to 10 days with or without medication. This condition recurred several times and between two acute episodes the patient beyond an intercritical phase. In other rare cases or chronic phase, several joints (polyarthritis) could be affected simultaneously.2,3 Recurrent attack and further deposition of MSU crystal will lead to a chronic condition and tophi develop.4,5,6 The deposition of tophi in the joint and bone will cause a serious damage to its structure and leading to deformities. Usually the development of tophi has a correlation with the severity of gout.
Epidemiology
The prevalence of hyperuricemia, gout and chronic tophaceous gout varies between countries.7 The WHO-ILAR-COPCORD stage I phase 3 researches in Bandungan, central Java, Indonesia, showed that the prevalence rate of gout and hyperuricemia in males 15 years of age and over is high compared to Caucasian populations. The prevalence of gout was 0.8% in the 4,683 people 15 years and older. Gout occurred in 1.7% of the men and 0.05% of the women. Acute gouty arthritis and chronic tophaceous gout were both found in the population sample.8 In Great Britain, the annual incidence rate (1971-1975), varying from 0.25 to 0.35 per 1000 and the prevalence of primary gout was estimated to be 2.3 per 1000.9 While in Taiwan the prevalence of gout was 0.60% in the rural area and 0.67% in the urban area.10 Another study from Indonesia, in northern part of Sulawesi indicating that chronic tophaceous gout was commonly seen among the population. Around 80% in the 208 population samples has developed tophi and various deformities.11 While in United State (USA) 35% in the 60 patients with gout...
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