Gouty arthritis in the adult.

Gouty arthritis, a crystal induced arthropathy, occurs as a result of monosodium urate precipitation in joint fluid, synovium, and soft tissues. The underlying abnormality is due to an imbalance in uric acid metabolism. Adult males are most commonly affected. Most of the affected females are postmenopausal, when the serum uric acid levels in women approach those in men. Characteristic radiographic findings include soft tissue tophi, punched out erosions with sclerotic margins, monoarticular or asymmetric polyarticular joint involvement, and relative preservation of joint space. Although the radiographic changes are quite characteristic, they occur only late in the course of the disease, after many years of clinical symptoms.