역절풍 歷節風

Joint-running wind disorder

Where they diverge

Traditional concepts do not map one-to-one onto modern diagnoses. Read the divergence note first.

The traditional concept is broader: defined by the pattern of severe pain migrating between joints, it places arthritides of different aetiology — gout and rheumatoid arthritis among them — under one name. Conversely it carries none of the findings that separate them. ICD-11 gout requires demonstration of urate crystals in synovial fluid and rheumatoid arthritis requires serology and acute-phase reactants; the traditional diagnosis requires neither.

Partial overlapbasis: literatureauto-generated · not individually reviewed

Research confidence: medium. The full assessment, in Korean, is in docs/PATTERN_RESEARCH_KCD_DISEASES.md.
The modern correspondences come from literature research, not from an official KCD or KTKP mapping, so the highest mapping confidence is not assigned.
Full evidence and citations are in docs/PATTERN_RESEARCH_KCD_DISEASES.md.
KCD does not carry the Donguibogam volume, so it is left blank here. It needs checking against the original text.
7 question(s) the research could not settle — see the research document.

Signs that need immediate medical assessment

When a single joint becomes acutely swollen and red with fever, do not assume a gout attack — septic arthritis must be excluded first. Margaretten ME, Kohlwes J, Moore D, Bent S. Does this adult patient have septic arthritis? JAMA 2007;297(13):1478-1488 (PMID 17405973, doi:10.1001/jama.297.13.1478) — across 14 studies of 6,242 patients, 653 had septic arthritis, about 10% of acute monoarthritis. Sensitivity was 85% for joint pain, 78% for a history of joint swelling and 57% for fever, so the absence of fever cannot rule it out. Older age, diabetes, a history of rheumatoid arthritis, previous joint surgery, hip or knee prostheses, skin infection and HIV infection all significantly raise the risk. The most informative tests are the synovial white cell count and polymorphonuclear percentage on aspiration; a synovial white cell count above 100,000/µL carries a likelihood ratio of 28.0. Referral to a facility that can perform joint aspiration is therefore needed, and choosing a period of observation on medication or acupuncture can result in joint destruction. Furthermore, since the ICD-11 definition of FA20 makes the absence of an alternative diagnosis an explicit requirement, symmetrical small-joint swelling with morning stiffness lasting six weeks or more warrants rheumatology assessment for anti-CCP, rheumatoid factor and acute-phase reactants (WHO ICD-11 MMS 2025-01, FA20 definition).

Tradition · what the text describes

Traditional pattern

역절풍 歷節風

The Donguibogam volume for this entry is unverified — KCD does not carry it.

Bridge · linked via official codes

Official codes

KCD U87.1 역절풍(歷節風) · Korean Medicine disease name

Modern · documented evidence

Modern diagnosis

FA25 Gout
FA20 Rheumatoid arthritis
FA01 Osteoarthritis of knee
MG30.01 Chronic widespread pain

Diagnosis names are WHO ICD-11’s own wording. Any second line is our description, not an ICD-11 label.

Related herbs

Licorice · Korean angelica · Siler root

Related formulas

Formulas that the KTKP record lists as indicated for this entry. The herbs above are linked through them.

호골산