Renal Basis of Hyperuricemia
Key Points • Approximately 90% of cases of hyperuricemia are caused by uric acid underexcretion from the kidneys. In addition, renal hypouricemia is caused by increased renal uric acid excretion….
RHEUMATOLOGY
Purine Metabolism in the Pathogenesis of Hyperuricemia and Inborn Errors of Purine Metabolism Associated With Disease
Key Points • Purine nucleotide synthesis and degradation form a crucial metabolic pathway for cell integrity and reproduction. • Phosphoribosyl pyrophosphate synthetase superactivity, a rare X chromosome–linked disorder, causes juvenile…
Genetics of Gout
Key Points • Serum urate levels are highly heritable and principally determined by the fractional excretion of uric acid in the kidney. The heritability of gout remains to be properly…
Treatment of Acute Gout
Key Points • Nonsteroidal antiinflammatory drugs (NSAIDs) (or cyclooxygenase-2–selective coxibs), systemic oral corticosteroids (prednisone or prednisolone), and colchicine are the primary therapy options for an acute gout attack. However, there…
Synovial Fluid Crystal Analysis
Key Points • The identification of monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluid or tissue biopsy samples is central to the definitive diagnosis of gout…
Diagnosis of Gout
Key Points • The aspiration of a joint with undiagnosed arthritis, or analysis of a tissue biopsy with subsequent visualization of monosodium urate (MSU) crystals, is considered the diagnostic standard…
Tophus Biology and Pathogenesis of Monosodium Urate Crystal–Induced Inflammation
Key Points • Tophi are macroaggregates of monosodium urate (MSU) crystals and in most tissues are formed as granulomas with cellular content that includes phagocytes, mast cells, B- and T-lymphocytes,…
Full-Thickness Rotator Cuff Tears
Abstract Arthroscopic management of rotator cuff tears is one of the greatest changes of the past 25 years. It has become a standard procedure, but the techniques are variable and…
Glenohumeral Instability
Abstract Glenohumeral instability can present with typical patterns of injury involving consistent structures. However, the degrees of injury and structures needed to address are often less defined. The approach to…
Diagnostic Arthroscopy and Normal Anatomy
Abstract The basics of diagnostic arthroscopy involve knowing where to place portals, understanding the external and internal anatomy of the shoulder, and having an organized approach to reviewing the structures…
