It is important that the misconceptions and myths held by the patient are discussed and dispelled and, most importantly, establish a clear understanding of “the plan” and the reason for initiating urate-lowering therapy (ULT).

A recent perspective by Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments.

William James famously wrote in Pragmatism, “There can be no difference anywhere that doesn’t make a difference elsewhere.” Gout treatment offers a striking medical example of that idea.

For many people, gout is viewed as an episodic disease: a painful flare, a short course of treatment, and then life returns to normal. However, as rheumatologists, we know that recurrent attacks can lead to joint damage and tophi if left untreated. Furthermore, the true burden of gout extends far beyond the musculoskeletal system.

Fibromyalgia (FM) affects 4–6% of the U.S. population, with nearly a 2 fold female predominance. Nociplastic pain underlies the pathophysiology of FM. CNS hypersensitization to both painful and non-painful stimuli occurs with little or no tissue pathology. Framing FM as a disorder of CNS processing is critical to diagnosis, treatment approaches and patient buy-in.