Clinical features of 4,000 gouty subjects in Japan.

The clinical aspects of gout were described based on the 4,112 patients observed in the same clinic. In this paper mainly, 2,455 cases seen between 1958 and 1973 were described based on a pretrospective computer assisted analysis. The age distribution of the patient had its peak at 50 years of age and the average age at the time of onset was 49.5 years for males and 54.2 years for females. Recently, in Japan, the incident of gout among second and third decades has increased. The sex distribution, showed a predominance in males (99%). Primary gout in females before the neopause was very rare, only 0.08% of all subjects. Cases with a definite hereditary incidence comprised 7.5% and male sibling involvement was the most frequent. 68.4% of the patients had their initial gouty attack in the MTP joint of the great toe. 47.4% of the patients had a history of gouty attacks in two or more joints. Cases with tophaceous gout composed 9.2%, however, recently it has been decreasing in number every year.