Dr Tuhina Neogi has put a new face on an ancient disease in this excellent little issue. The epidemiology of gout is a frightening story. In a disease where we have a known pathogenesis and effective treatment along with prevention strategies, we find the problem is increasing! Why is this happening and is it reversible? Dr Neogi tells us straight away that gout is now the most common form of inflammatory arthritis in the United States, yet our medical schools and house officer-training programs likely are not responsive to this important fact. We have learned from this issue that gout has multiple phases, and the asymptomatic phase is becoming increasingly recognized as important, especially in terms of associated comorbidities. Advanced imaging has now given us a window into newer pathologic mechanisms for joint damage. Structural damage in gout appears to be multifactorial and the story is unfolding regarding the importance of urate-lowering treatment especially in the asymptomatic phase of the disease. Finally, it is surprising how little we know about CPPD deposition diseases—this is a call to arms for our research establishment. The role of calcium deposition in its various forms appears to be a major player in initiating and sustaining inflammation leading to joint destruction. This very timely issue is welcome and Tuhina has done an excellent job.
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Gout and Crystal Arthropathies
Diagnosis and Clinical Manifestations of Calcium Pyrophosphate and Basic Calcium Phosphate Crystal Deposition Diseases
Emerging Therapies for Gout
