Department of Medicine, Division of Geriatrics, University of Padova, Padova, Italy.
Clin Rheumatol. 2012 Jul;31(7):1127-32. doi: 10.1007/s10067-012-1956-x. Epub 2012 Feb 25.
Gout is the most common cause of arthritis in the elderly. Its incidence among older people has risen worldwide due to an increase in risk factors such as renal diseases, metabolic syndrome, and a diet rich in purines. In older age, tophaceous gout may affect different joints from its classical presentation, due to other concomitant musculoskeletal diseases, but specific data on its epidemiology and clinical aspects in the elderly are limited to a few case reports. The present review focuses on the distinctive aspects of tophaceous gout in the elderly, revisiting all our clinical cases seen from 1990 to December 2011. Our findings indicate that: tophaceous gout can affect several joints in the elderly, including some unusual sites; its incidence is similar in both genders in the elderly even if the latency period between its initial diagnosis and the onset of tophi is higher in men; and vertebral localizations are rising and often solitary. The components of metabolic syndrome are the most common medical conditions associated with tophaceous gout. In conclusion, tophaceous gout in the elderly may be a growing medical problem and cause of disability in years, partly because of the new sites involved.
痛风是老年人中最常见的关节炎病因。由于肾脏疾病、代谢综合征和富含嘌呤的饮食等风险因素的增加，世界各地老年人的痛风发病率有所上升。在老年时，由于其他伴随的肌肉骨骼疾病，痛风石可能会影响与经典表现不同的关节，但老年人中关于其流行病学和临床方面的具体数据仅限于少数病例报告。本综述重点关注老年痛风石的独特方面，重新审视了我们从 1990 年到 2011 年 12 月期间所见的所有临床病例。我们的发现表明：痛风石可影响老年人的多个关节，包括一些不常见的部位；即使男性痛风石发病前的潜伏期较高，但老年人群中男女发病率相似；脊椎部位的发病率上升，且常为单发。代谢综合征的组成部分是与痛风石相关的最常见的医疗条件。总之，老年痛风石可能是一个日益严重的医疗问题，并在未来几年成为残疾的原因，部分原因是涉及新的部位。
