Background/Purpose: Gout has been recognized and described since antiquity. However, the terms used to describe the disease lack standardization. The aim of this study was to identify and categorise the labels used for the basic disease elements of gout in contemporary medical literature.

Methods: We analysed articles from the ten highest ranked general rheumatology and five highest ranked general internal medicine journals according to 2015 Thomson-Reuters Journal Citation Reports for the period January 2012 to January 2017. For each journal, relevant articles were identified by the search terms ‘gout’ and/or ‘hyperuricemia’ using MEDLINE. No exclusion criteria were applied. Labels were extracted from each article and categorised according to the descriptions given to the basic disease elements as shown in table 1. A label was determined to be ‘unique’ if it used different words or phrases to describe an element.

Results: There were 549 articles from 15 journals over the five-year period. A total of 3,220 labels were identified, of which 342 were unique. Table 1 shows the number of unique labels identified for each element, and the most commonly used label. For a few elements, there was consistency in the label used; for example, 99.0% of articles describing ‘an elevated circulating level of the final enzymatic product generated by xanthine oxidase in purine metabolism in humans’ used the label ‘hyperuric(a)emia’, and 92.5% of articles describing ‘a discrete collection of pathogenic crystals with associated host-response tissue’ used the label ‘tophus’. However, for most elements, a wide range of labels was used with no dominantly used label (Table 1). The element ‘an episode of acute inflammation triggered by the presence of pathogenic crystals’ had the largest number of unique labels; 162 unique labels were identified, and 33.6% articles used at least 4 unique labels for this element. For ‘the circulating form of the final enzymatic product generated by xanthine oxidase in purine metabolism in humans’, there were two widely used labels; ‘uric acid’ (63.0% articles) and ‘urate’ (62.5% articles); with both labels used interchangeably in 25.9% articles.

Conclusion: The existing nomenclature of gout disease elements is imprecise and inconsistent. This imprecision may be a barrier to effective communication in both clinical and research settings. Consensus regarding the nomenclature of disease elements is required.

Table 1 – Unique labels identified for the basic disease elements of gout in 549 disease-relevant articles