Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Pathophysiology and Treatment of Gout Arthritis; including Gout Arthritis of Hip Joint: A Literature Review

  • Yonghan Cha (Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Jongwon Lee (Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Wonsik Choy (Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Jae Sun Lee (Advanced Therapy Center, Catholic Kwandong University International St. Mary's Hospital, College of Medicine, Catholic Kwandong University) ;
  • Hyun Hee Lee (Department of Orthopedic Surgery, Catholic Kwandong University International St. Mary's Hospital, College of Medicine, Catholic Kwandong University) ;
  • Dong-Sik Chae (Department of Orthopedic Surgery, Catholic Kwandong University International St. Mary's Hospital, College of Medicine, Catholic Kwandong University)
  • Received : 2023.06.29
  • Accepted : 2023.08.10
  • Published : 2024.03.01
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Abstract

Gout is triggered by the accumulation of uric acid in the body, leading to hyperuricemia. Genetic, metabolic, and environmental factors can influence this condition. Excessive uric acid buildup results in the formation of monosodium urate (MSU) crystals, which precipitate in specific areas of the body, including the joints, where they can cause symptoms of gout. While the acute and chronic symptoms of gout have been well-documented, diagnosis of gout affecting the hip joint poses significant challenges. The global incidence of gout, the most prevalent form of inflammatory arthritis, is on the rise. Evaluation of the clinical signs, laboratory results, and imaging results is generally required for diagnosis of gout in cases where MSU crystals have not been detected. Hyperuricemia is considered a primary cause of arthritis symptoms, and comprehensive guidelines for treatment are available. Therefore, the choice of medication is straightforward, and moderate effectiveness of treatment has been demonstrated. Gout is a chronic disease, requiring lifelong uric acid-lowering medications, thus application of a treatment strategy based on the target blood uric acid concentration is necessary. Consequently, cases of gout will likely be observed more frequently by hip surgeons in clinical scenarios in the future. The objective of this review is to provide an overview of the pathophysiology of gout and subsequently examine recent advances in diagnostic methods and therapeutic agents based on an understanding of its underlying mechanisms. In addition, literature on gout-related issues affecting the hip joint, providing a useful reference for hip surgeons is examined.

Keywords

Acknowledgement

This review article was presented at the Clinical Practice Guidelines Symposium of the Korean Hip Society on May 13, 2023.

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