Consistency of the Sonographic Image (Double Contour Sign) in Patients with Gout after Ambulation

Abstract

The aim of this study was to know whether or not any crystal shedding occurs after ambulation in patients with gout and how it affects the consistency of the sonographic image of crystal deposition on hyaline cartilage. A total of 18 consecutive patients (29 knees), 11 with early gout (17 knees) and seven with chondrocalcinosis (12 knees), were prospectively scanned by ultrasound. Examination at rest and after ambulation was performed in each patient. Crystal aggregates were measured in a transverse view. Crystal shedding after ambulation was noted in two patients (two knees) with gout. However, crystal deposits on the surface of the articular cartilage in gout kept invariable size. In patients with chondrocalcinosis, crystal shedding by ambulation was absent. The conclusion of this study is that the size of crystal deposits on the hyaline cartilage in gout and chondrocalcinosis assessed by ultrasound is not modifiable by ambulation.

Interplay between fat, muscle, bone mass, and oteophytes and risk for tophaceous gout

“…Tophaceous gout has some radiological changes, such as tophi and intra-articular erosions. Hypertrophic bone changes have also been noted 8 9. These findings may provide reasons about the mechanisms of bone remodeling in tophaceous gout.…”

“…Hypertrophic bone changes have also been noted. 8 9 These findings may provide reasons about the mechanisms of bone remodeling in tophaceous gout. However, whether it can fully explain that the correlation between bone density and tophaceous gout remains uncertain.…”

Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout

“…Ultrasonography has high diagnostic accuracy in demonstrating tophaceous deposits in joint spaces, synovium, cartilage, and adjacent soft tissues. Deposition of monosodium urate crystals on the most superficial layer of hyaline cartilage results in "double contour sign" which is an irregular echogenic line demonstrated on ultrasonography and notably manifests during gout flare-up in patients with a prior history of gout attacks, and with asymptomatic hyperuricemia [5]. However, the sensitivity of these findings on ultrasonography ranges between 25% and 95% [6].…”

Imaging of Joints and Bones in Autoinflammation

“…One of the most available, inexpensive, and non-invasive imaging techniques in point-of-care rheumatology is the ultrasound. Using ultrasounds, MSU depositions may be demonstrated in tendons, periarticular soft tissue, and articular cartilage (i.e., the double-contour sign) [ 31 ] with high sensitivity and specificity [ 32 , 33 ]. Longitudinal studies have also demonstrated the capacity of ultrasound to monitor diseases [ 34 ].…”