Search

Competing Interests: G. Chalès déclare des interventions ponctuelles - rapports d’expertise, activités de conseil,conférences,actions de formation - pour Mayoly Spindler,Ipsen, Menarini,Novartis, Grünenthal et avoir été pris en charge à l’occasion de déplacements pour congrès par Menarini, Ipsen, Grünenthal.

Despite the continuing undertreatment, gout has seen something of renaissance in terms of research into epidemiology, genetics, diagnostic criteria, imaging and new treatments. In Metropolitan France, gout prevalence was estimated at 0.9 %. A recent genome-wide association study identified new loci of interest. An easy-to-use diagnostic rule for gout care shows good performance in primary care when joint fluid analysis is not available. Gout is associated with a number of comorbidities, which may have an effect on the development of gout and on the choice of therapeutic agents. Ultrasound allows non invasive and quick detection of urate microcrystals aggregates. Low-dose colchicine may be the preferred treatment option in acute gout. Agents blocking interleukin 1 (canakinumab) can be used in acute gout when NSAIDS and colchicine are contraindicated or not tolerated. Xanthine-oxydase inhibitors (allopurinol, febuxostat) are used in first line to reach the therapeutic serum urate target < 60 mg/L. Other agents under investigation are urate transporter inhibitors promoting renal uric acid excretion, such as lesinurad, and the recombinant urate pegloticase to directly catabolise urate. The combined targeting of two different modes of action has superior urate lowering effects. Patient education is essential in chronic gout management to improve adherence to treatment.

The diagnosis of non-traumatic knee complaints relies on history taking and clinical examination, joint fluid analysis and imaging tests. This paper aims at reminding the benefits of conventional radiography and clarifying the role of ultrasound and magnetic resonance imaging based on illustrated case reports.

Arthropathy is a major and distinctive manifestation of hemochromatosis, resembling degenerative joint disease with involvement of unusual articular sites, almost identical to the arthropathy in calcium pyrophosphate dihydrate crystals deposition disease (chondrocalcinosis), associated with osteoporosis. Hemochromatosis is the clinical condition of iron overload; it can be genetic or secondary. It is important to know how to diagnose early genetic hemochromatosis since it is a frequent, life-threatening and treatable condition. Early bio-clinical symptoms are weakness, arthralgias and increase of serum tranferrin saturation.