Bomalaski J S, Lluberas G, Schumacher H R
Arthritis Rheum. 1986 Dec;29(12):1480-4. doi: 10.1002/art.1780291209.
We aspirated synovial fluid from the knees of 50 patients with asymptomatic, nontophaceous gout, in whom synovial fluid monosodium urate (MSU) crystals had previously been documented in the knees or other joints. Fifty-eight percent of these asymptomatic patients had MSU crystals in their knee joints. Serum uric acid levels, serum creatinine levels, volume of synovial fluid aspirated, and cell counts of the aspirated fluid did not differentiate the MSU crystal-positive group from the group without MSU crystals. Clinical factors such as alcohol abuse, coronary heart disease, hypertension, duration of gout, duration of the intercritical period, and drug therapy did not differentiate the 2 groups. Nineteen patients consented to aspiration of their other knee. Seven of these patients (37%) had MSU crystals bilaterally, and 6 patients (32%) had them unilaterally. The implications of the persistence of MSU crystals (including those in intracellular locations) in many patients, despite normalization of serum uric acid levels, should be determined. Knee joint aspiration is a sensitive method for the demonstration of MSU crystals in asymptomatic patients. The procedure might also be useful in documenting these crystals in patients who have had attacks of arthritis with features consistent with a diagnosis of gout, but in whom MSU crystals have not been documented.
我们从50例无症状、非痛风石性痛风患者的膝关节抽取滑液，这些患者先前在膝关节或其他关节中已记录到滑液尿酸钠（MSU）结晶。这些无症状患者中有58%在其膝关节中有MSU结晶。血清尿酸水平、血清肌酐水平、抽取的滑液量以及抽取液的细胞计数均无法区分MSU结晶阳性组和无MSU结晶组。酗酒、冠心病、高血压、痛风病程、发作间期时长以及药物治疗等临床因素也无法区分这两组。19例患者同意对其另一个膝关节进行抽取。其中7例患者（37%）双侧有MSU结晶，6例患者（32%）单侧有MSU结晶。尽管血清尿酸水平已恢复正常，但许多患者中MSU结晶（包括细胞内的结晶）持续存在的影响仍有待确定。膝关节穿刺是在无症状患者中检测MSU结晶的一种敏感方法。该操作对于记录那些有符合痛风诊断特征的关节炎发作但未记录到MSU结晶的患者体内的这些结晶可能也有用。
