L A Coleman, Marshfield Clinic Research Foundation, Marshfield, WI, USA

R Roubenoff, Millennium Pharmaceuticals, Inc., Cambridge, MA, USA and Tufts University, Boston, MA, USA

© 2005 Elsevier Ltd. All rights reserved.

A diagnosis of gout refers to a group of metabolic conditions resulting from the deposition of monosodium urate crystals around and in the tissues of joints. The precise mechanism by which uric acid leads to gouty arthritis remains somewhat unclear; various contributing factors are discussed. Clinically, gout typically involves an episodic monoarthritis; if untreated, acute gout can segue into a deforming, chronic polyarthritis that may be difficult to distinguish from rheumatoid arthritis. Improved prevention and treatment of gout have occurred during the latter half of the twentieth century; however, recent research has focused on the link between serum urate, coronary artery disease, and insulin resistance syndrome. Dietary management of gout no longer seems to be focused on restriction of foods with a high purine content but, rather, on the treatment of metabolic disorders commonly associated with gout: obesity, insulin resistance syndrome, and dyslipidemia.

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