Monday, 25 April 2016

Most Common Disease of 50+: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs)- Gout - The Diagnosis

Kyle J. Norton (Scholar and Master of Nutrients, all right reserved)Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(*).

Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Gout mostly effected one joint is an acute and recurrent condition of arthritis as a result of uric acid building up in blood, inducing joint inflammation.

                             The Diagnosis

According to the Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Feb. Report No.: 15(16)-EHC026-EF.AHRQ Comparative Effectiveness Reviews(125).
if you are experience SHARP pain in the joint with visual symptoms of collection of urate crystal deposit and other clinical signs and symptoms of gout, your doctor may order the below tests
1. Joint fluid test 
Withdraw fluid from affected joint to test for sign of urate crystal accumulation for confirmation of gout.

2. Blood test
Blood test is necessary to measure levels of uric acid for gout and creatinine for kidney function in your blood. According to the University of Auckland, measured blood test in people with gout has caused confusion about the details of urate measurement in suboptimal care(126), as the measurement may not be accurate as some some people with high levels of uric acid levels, have never experienced gout. And some people have signs and symptoms of gout, but don't have higher levels of uric acid in their blood(127).

3. X-ray imaging(125)
The aim of the test is to rule other causes of inflammation of joints. In case of negative or inconclusive, other tests such as ultrasound and dual energy CT scan to provide additional information in patients(128),

4. Ultrasound(125)
The aim is to detect any urate crystals deposit in a joint or in a tophus for confirmation of gout when X ray is inconclusive and negative(128). Dr. Codreanu C and Dr. Enache L said, "adding US to the clinical and serological features will significantly improve the sensitivity of proposed criteria. The ability of high resolution US to detect crystalline deposits of monosodium urate in joints and soft tissues is well recognized"(129)

5. Dual energy CT scan(125)
The aim of the test is to detect any any urate crystals deposit in a joint or in a tophus even without sign of acute inflammation. "Dual-energy computedtomography (CT) contributes over conventional single-energy CT,........ Particular emphasis will be placed on acute gout, bone marrow edema, acute renal colic, acute cardiovascular and neurovascular emergencies aswell as characterization of abdominal incidentalomas" according to the joint study led by the University of British Columbia.

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(125) Diagnosis of Gout [Internet].Editors Newberry SJ, FitzGerald J, Maglione MA, O'Hanlon CE, Han D, Booth M, Motala A, Tariq A, Dudley W, Shanman R, Shekelle PG.(PubMed)
(126) Urate testing in gout: why, when and how by Dalbeth N1, Winnard D, Gow PJ, Boswell DR, Te Karu L, Lindsay K, Arroll B, Stamp LK.(PubMed)
(127) Tests and diagnosis By Mayo Clinic Staff(127)
(128) Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-ray by Rettenbacher T1, Ennemoser S, Weirich H, Ulmer H, Hartig F, Klotz W, Herold M.(PubMed)
(129) Is ultrasound changing the way we understand rheumatology? Including ultrasound examination in the classification criteria of polymyalgia rheumatica and gout by Codreanu C1, Enache L2.(PubMed)


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