Goutte : critères de diagnostic, de classification et de qualité de vie

Abstract

Gout is a frequent disease with a unique pathognomonic diagnostic feature, i.e., monosodium urate (MSU) crystal identification in synovial fluid or in tophus. This “gold standard” may be missing since general practitioners (and even rheumatologists) often make a diagnosis of gout on clinical grounds, too rarely looking for joint tap and synovial fluid examination. In addition, routine or even hospital laboratories might miss MSU crystal identification because of insufficient skills and techniques. Classification criteria have been proposed in the 1960–1970s, with emphasis on characteristic features of crystal-induced inflammation, and always MSU crystal identification. The OMERACT task force for gout is currently developing a set of tools for outcome measures useful in clinical trials for new drugs which are moving gout out from old ages and old drugs to a new era. Finally, recent development of specific outcome measures to evaluate global or location-specific disabilities, as well as health-related quality of life, should allow comprehensive assessment of functional consequences, sometimes severe, of the disease.