JOSEPH M. BRILL, M.D.; DANIEL J. MCCARTY JR., M.D.
Recently a rapid, simple technique using polarized light microscopy for urate crystal identification in synovial fluid was developed by McCarty and Hollander.1 Acute gouty attacks were marked by phagocytosis of the crystals by mononuclear and polymorphonuclear leukocytes.2 The sensitivity and specificity of the procedure is such that it has been described as a pathognomonic test for gout;3 90 of the last 91 gouty joint fluids examined in our laboratory have contained urate crystals.
Interest in the sterile host response peculiar to acute gouty arthritis was reawakened recently with the demonstration of a phlogistic response to synthetic microcrystalline sodium urate
BRILL JM, MCCARTY DJ. "Studies on the Nature of Gouty Tophi" by Max Freudweiler, 1899: (An Inflammatory Response to Injected Sodium Urate, 1899). Ann Intern Med. ;60:486–505. doi: 10.7326/0003-4819-60-3-486
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Published: Ann Intern Med. 1964;60(3):486-505.
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