Villous Synovitis Static and Non-gouty in Origin
In short, the joint disorder is fundamentally of static or mechanical origin, and, this being so, the results of anti-gouty treatment are open to a further misinterpretation. The victims, as we have said, exhibit very generally a tendency to obesity. Now, Ebstein and many others hold the view that obesity and gout have affinities. Ebstein, moreover, believes that treatment directed to the reduction of body weight will check the appearance of gouty arthritis or ameliorate the same when avowed. What happens is this: these corpulent subjects are placed on a special dietary. Hydrocarbon foodstuffs are limited, bread, amylaceous food and liquids being also restricted. Naturally, pari passu with reduction in their body weight, their overburdened joints become more equal to their office. But those who assume that the chronic arthritis is of gouty origin attribute, and, we think, wrongly, the beneficial results attained to correction of the underlying “gouty” habit.
We prefer to subscribe to the simpler or mechanical theory, and in view of the widespread and, as we believe, erroneous belief in the gouty nature of this arthritis, we take the liberty of appending the salient features of these cases, while adding further a few remarks on the differential diagnosis of other symmetrical affections of the knees which may also be wrongly attributed to gout.