Athan N Tiliakos1, Nicholas A Tiliakos. 1. Department of Internal Medicine, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA.
Abstract
BACKGROUND: Synovial fluid urates are traditionally measured as supernatants, and levels are reported to be comparable to serum levels. OBJECTIVE: We have decided to attempt to define a more accurate parameter of gouty urate load in the joint fluid. METHODS: In 23 gouty joints of various activity, the urate level was determined by both the traditional method and by heating and agitation to dissolve crystals yielding total joint fluid urate (TJFU). RESULTS: TJFU was higher than the serum level or traditional urate level, and the gradient (TJFU-synovial fluid urate) was proportional to gouty activity. CONCLUSIONS: We propose that TJFU is more representative of the pathophysiology of gout and deserves further evaluation of its implications.
BACKGROUND: Synovial fluid urates are traditionally measured as supernatants, and levels are reported to be comparable to serum levels. OBJECTIVE: We have decided to attempt to define a more accurate parameter of gouty urate load in the joint fluid. METHODS: In 23 gouty joints of various activity, the urate level was determined by both the traditional method and by heating and agitation to dissolve crystals yielding total joint fluid urate (TJFU). RESULTS: TJFU was higher than the serum level or traditional urate level, and the gradient (TJFU-synovial fluid urate) was proportional to gouty activity. CONCLUSIONS: We propose that TJFU is more representative of the pathophysiology of gout and deserves further evaluation of its implications.