ABSTRACT
The goals in managing patients with gout and hyperuricemia are to terminate
the acute attack as promptly as possible; to prevent recurrences of acute gouty
arthritis; to prevent or reverse complications of the disease resulting from
deposition of sodium urate or uric acid crystals in joints, kidneys, or other sites;
and to prevent or reverse associated conditions, such as hypertension, obesity,
hypertriglyceridemia, and alcoholism. Given that the cause of gout is known, it
can be diagnosed with absolute certainty, and excellent therapies exist, then these
goals should be achievable. Although more common, arthropathies caused by
calcium pyrophosphate dihydrate (CPPD) crystal deposition are more difficult to
treat because therapies that eliminate the cause (i.e., eliminate the crystals) are
not available. Therefore the management of these diseases is more supportive and
palliative in nature. Below the strategies available to help patients with various
forms of crystal-induced arthropathy are reviewed.
