HERMAN PEPPER, M.D.; LOUIS MANN, M.D.
The clinical, biochemical, and histiologic manifestations of typical gout have been described extensively, and the diagnosis is usually made without difficulty. The differential diagnosis of irregular or atypical gout, however, continues to be a problem. Irregular gout has many signs and symptoms which are not characteristic of typical gout. It is insidious in onset, causes mild arthritis, usually affects women, and progresses slowly without remission. A family history of the disease is rarely elicited. Tophi are absent.1 Serum uric acid levels are at the upper limits of normal or slightly higher. The diagnosis can only be made by demonstrating sodium
PEPPER H, MANN L. LEG ACHE: A SYMPTOMATIC INDICATION OF IRREGULAR GOUT12. Ann Intern Med. ;54:267–273. doi: 10.7326/0003-4819-54-2-267
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Published: Ann Intern Med. 1961;54(2):267-273.
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