The pathological appearance of gouty joints is characteristic.
Macroscopic examination of joints affected by gout reveals a nodular, white, chalky appearance.
Polarized microscopy of gout demonstrates negative birefringent needle-shaped MSU crystals..
Cell types
The cells most studied in gouty inflammation are leucocytes - in particular, neutrophils and macrophages.
Addition of MSU crystals to neutrophils results in cell death and release of lysosomal and cytoplasmic enzymes..
Demonstration of urate crystals in synovial fluid or biopsy helps in confirming the diagnosis of gout.
However, fine-needle aspiration cytology (FNAC) of periarticular soft-tissue nodules is a valuable tool in the diagnosis of gout.Aug 5, 2022.
Histology showed nodular aggregates consisting of acellular, amorphous, pale eosinophilic material surrounded by palisading arrangement of histiocytes and multinucleated giant cells.
The material showed needle-like crystals which appeared brightly anisotropic under polarized light.Jan 11, 2023.
Gout may be overlooked in cytology samples, particularly when there is no prior history, a presentation such as a soft tissue mass, or when there are samples with obscuring elements (eg, blood, inflammation, or giant cells) and little crystal deposition
Indeed, only 7 patients (21%) in our study cohort had a clinical history of gout
It often presents with painful joint effusion and commonly is diagnosed either by clinical examination and elevated serum uric acid level 15 or by cytologic examination of an effusion
2, 3 The cytologic diagnosis of gout is contingent on the identification of the characteristic crystals in joint fluid
Gout is a systemic disorder caused by accumulation of urate crystals in joints and soft tissues
Affected individuals are most often older males, although women can be affected as well, mostly after menopause
