Concentration of Urate by Differential Diffusion: A Hypothesis for Initial Urate Deposition
For the sake of argument, I’ve decided to build this talk around the base of the great toe. We now accept the idea that acute gouty arthritis has a physical cause: the sodium urate monohydrate crystal. We can logically extend that concept, then, to say that there must be a physical reason or reasons why one joint receives such a disproportionate share of these crystals and of the miseries they inflict. Ideally, that same reason should explain why attacks are provoked by exertion, why they occur in the middle of the night and why gout usually strikes patients in their forties when hyperuricemia may have been present since puberty.
KeywordsSmall Joint Tritiated Water Disproportionate Share Sesamoid Bone Differential Diffusion
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