How well do we recognise gout disease?

Abstract

Objective: The clinical burden of gouty arthritis has historically been well recognized; however, gout is often misdiagnosed and mismanaged. In this study, we aimed to evaluate the diagnoses and treatments given to gout patients admitted to different specialties. Methods: Patients who were diagnosed with gout attacks and treated by a rheumatologist were included, while patients with other non-gout rheumatic diseases (connective tissue diseases, rheumatoid arthritis, spondyloarthropathies, calcium pyrophosphate disease, etc.) were excluded. The branches the patients applied to during the attack, the treatments and diagnoses they received drugs, the number of attacks they had, demographic data, comorbidities, and laboratory data were recorded retrospectively. Results: 424 gout patients were included. Patients were mostly male (70.7%). The mean age was 62.4± 12.4 years, and women were older than men (67.9±10 vs 62.4±12 years, p<0.001). Hypertension was the most common comorbidity, observed in 230 patients (54.2%). Among the patients who applied, 86 (20.2%) had previously been diagnosed, while 338 (79.7%) were diagnosed for the first time. The number of patients who had their first attack was 210 (49.5%), the number of patients who had their second attack was 88 (20.7%), and the number of patients who had ≥3 attacks was 126 (29.7%). The most commonly involved joint was the 1st metatarsophalangeal joint (MTF) and the second most commonly involved joint was the ankle joint. The rate of gout diagnosis was higher in patients presenting with podogra. The initial departments consulted during the incident were the emergency department first, followed by orthopedics and infectious diseases. Gout was the most common diagnosis, followed by trauma and injury, cellulitis, septic arthritis, and soft tissue infection. Nonsteroidal anti-inflammatory drugs(NSAIDs) were the most frequently prescribed drugs, followed by antibiotics and colchicine. Conclusion: Gout is still not sufficiently recognized. Different diagnoses and treatments other than gout are made in applications to different branches. All physicians, regardless of their specialties, may be the first to see patients with gout attacks and therefore play a critical role in the diagnosis and treatment of these patients. With correct diagnosis and treatment, many visits to the doctor can be reduced.

Keywords

• Gout
• Attack
• Gout mimics

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