GOUTY-ARTHRITIS IN NODAL OSTEOARTHRITIS

Objective. To analyze the clinical features and identify factors assoc iated with the development of gouty arthritis in nodal osteoarthritis (OA). Methods. Thirty-two consecutive patients (21 women and 11 men: m ean age 75.8 pears) with both nodal OA and crystal proven acute gout a nd/or tophi of distal/proximal interphalangeal (DIP/PIP) joints were s tudied between 1986 and 1994. Results, Tophi of DIP and/or PIP joints were present in 29 (90%) patients; alone in 9 and together with acute DIP or PIP gouty arthritis in 20. Three patients had acute DIP or PIP gouty episodes but no digital tophi. Mean pretreatment serum urate was 614.9 +/- 163.2 (range 422-1058 mu mol/l). Risk factors for gout incl uded diuretic use (81%), renal failure (59%), hypertension (66%). alco holism(22%), prophylactic low dose ASA (20%), and a positive family hi story (16%) of patients. Conclusion. The coexistence of gouty arthriti s in nodal OA is important to recognize and treat, particularly in eld erly women with renal failure, hypertension, or cardiac failure who ar e receiving longterm diuretic therapy.