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Editorial
. 2021 Mar;24(3):297-299.
doi: 10.1111/1756-185X.13999. Epub 2021 Feb 1.

Slowly melting the urate snow in joints: Explaining gout attacks to patients

Toru Shimizu  1 , Matthew John Rooks  2
Affiliations
Editorial

Slowly melting the urate snow in joints: Explaining gout attacks to patients

Toru Shimizu et al. Int J Rheum Dis. 2021 Mar.
No abstract available

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Figures

Figure 1
Figure 1
Hyperuricemia. We compared hyperuricemia to snowfall and the state of accumulating monosodium urate crystals to snow cover. When snowfall continues, snow cover gradually increases on the roof (joint lining). The snow cover eventually reaches a dangerous level on the roof.
Figure 2
Figure 2
Crystal shedding. When the monosodium urate burden exceeds the limit of stability, triggered by a variety of stimuli, a block of crystals sheds into the joint cavity. This crystal shedding (avalanche) evokes acute gouty arthritis, otherwise known as a gout attack or a flare.
Figure 3
Figure 3
Unexpected gout attacks. Notice that after an avalanche occurs, the remaining snow cover becomes very unstable and easily breaks off. Over‐administration of urate‐lowering drugs often evokes unexpected, repeated, and prolonged gout attacks. This instability might persist for 2‐3 months.
Figure 4
Figure 4
Slowly melting snow. It is extremely important that the snow cover on the roof should be melted slowly and gently, so that avalanches will gradually disappear. By steadily controlling serum urate, gout attacks become less severe and less frequent.
Figure 5
Figure 5
No more gout attacks. When the snow has melted away (accumulated monosodium urate crystals have disappeared), avalanches (gout attacks) no longer occur.
See this image and copyright information in PMC

References

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