Gout pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pathophysiology

Gross Pathology

Kidney: Uric Acid Deposition: Gross, an excellent example of gouty nephropathy with deposits and excavation in pyramids

Kidney: Papillary Necrosis: Gross, yellow foci in pyramids, a gout kidney

Bone, synovium: Gout: Gross natural color opened joint with extensive white deposits of uric acid

Bone, synovium: Gout: Gross natural color close-up of extensive uric acid deposits

Kidney: Gout: Gross natural color close-up view of uric acid deposit in medullary pyramid

Kidney: Uric Acid Deposition: Gross natural color close-up and excellent view of opaque material in medullary pyramid of adult kidney

Bone, synovium: Gout: Gross natural color section through sternum and clavicle showing very well uric acid deposits in the periarticular tissue

Urinary Tract: Staghorn calculi in renal pelvis, Gout

Gout; Bursa of Knee

Kidney: Uric Acid Deposition: Gross, infant kidney with excellent uric acid streaks

Kidney: Uric Acid Deposition: Gross good example uric acid streaks in medulla (very ischemic kidney)

Kidney: Uric Acid Nephropathy: Gross, natural color, an excellent view of hydronephrosis with inflamed pelvis and multiple calculi with deposits in medullary pyramids

Kidney: Uric Acid Infarcts: Gross natural color opened kidney showing marked ischemia with dark red medullary pyramids which contrast sharply with the uric acid deposits

Kidney: Uric Acid Infarcts: Gross natural color typical lesion well shown

Kidney: Uric Acid In Medulla: Gross natural color cut surface of kidney uric acid easily seen

Kidney: Uric Acid Infarcts: Gross natural color close-up outstanding photo of the uric acid streaks in medullary pyramids

Knee Joint: Gout. Heavy Deposition of Urate Crystals in Articular Cartilage

Microscopic Pathology

Gout (Needles, no birefringence, monosodium urate)

Skin: Tophus: Micro med mag H&E uric acid deposits with giant cells. Easily recognizable as gout or uric acid tophus

Skin: Tophus: Micro med mag H&E easily recognized uric acid deposit lesion from elbow

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout

Bones-Joints: Gout, alcohol fixed tissues, monosodium urate crystals

Bones-Joints: Gout, alcohol fixed tissues, monosodium urate crystals

Bones-Joints: Gout, alcohol fixed tissues, monosodium urate crystals

Bones-Joints: Gout

Bones-Joints: Gout

Joint: Gout

Joint: Uric Acid Crystals in Acute Gout

Sources

Copyleft images obtained courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA) Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

References