Rheumatology Advance Access originally published online on April 27, 2007
Rheumatology 2007 46(7):1116-1121; doi:10.1093/rheumatology/kem058
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnosis of gout by ultrasound
Rheumatology Division, Department of Medicine Cooper University Hospital, Camden and 1Rheumatology Division, Department of Medicine, UMDNJ/RWJMS, New Brunswick, NJ, USA.
Correspondence to: R. Thiele, Department of Medicine, Allergy/Immunology & Rheumatology Division, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 695, Rochester, NY 14642, USA. E-mail: ralf_thiele{at}urmc.rochester.edu
 |
Abstract |
|---|
Objectives. To establish the usefulness of ultrasonography (US) for diagnosing gout and to determine whether there are sonographic features that are characteristic for gout but not for other arthropathies.
Methods. We retrospectively compared joint images of gout patients with matching images from patients with other rheumatic conditions. Images of 37 joints of 23 patients with monosodium urate (MSU) crystal-proven gout were reviewed. MSU crystals were identified in at least one joint in each patient. Our control group had 23 randomly selected patients with 33 examined joints with rheumatic conditions other than gout.
Results. Specific diagnostic features included a hyperechoic, irregular band over the superficial margin of the articular cartilage described as a double contour sign in 92% of gouty joints and in none of the controls (P < 0.001); hypoechoic to hyperechoic, inhomogeneous material surrounded by a small anechoic rim, representing tophaceous material, was seen in all gouty metatarsophalangeal (MTP) joints, in all metacarpophalangeal (MCP) joints and in none of the controls (P < 0.001); erosions adjacent to tophaceous material were seen in 65% of MTP joints and in 25% of MCP joints. One erosion was seen in a MTP joint in a control patient with psoriatic arthritis.
Conclusions. US can detect deposition of MSU crystals on cartilaginous surfaces (P < 0.001) as well as tophaceous material and typical erosions. US may serve as a non-invasive means to diagnose gout.
KEY WORDS: Gout, Gouty arthritis, Tophi, Ultrasonography, Diagnostic imaging
Submitted 29 December 2006;
revised version accepted 9 February 2007.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. D. Carter, R. P. Kedar, S. R. Anderson, A. H. Osorio, N. L. Albritton, S. Gnanashanmugam, J. Valeriano, F. B. Vasey, and L. R. Ricca An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs Rheumatology, November 1, 2009; 48(11): 1442 - 1446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Perez-Ruiz Treating to target: a strategy to cure gout Rheumatology, May 1, 2009; 48(suppl_2): ii9 - ii14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-J. Chang, C.-J. Chen, F.-C. Tsai, H.-M. Lai, P.-C. Tsai, M.-H. Tsai, and Y.-C. Ko Associations between gout tophus and polymorphisms 869T/C and -509C/T in transforming growth factor {beta}1 gene Rheumatology, May 1, 2008; 47(5): 617 - 621. [Abstract] [Full Text] [PDF]
|
|