“…Hung et al comment on the lack of control group in our study, and they suggest a double-blind, controlled study to explore the effectiveness of ULT, and they comment on the lack of information regarding blindness of operators and participants. 1 We certainly agree on a randomised controlled trial (RCT) being necessary to confirm our findings, which are based on an observational study without a control group, where neither sonographers nor patients were blind to the treatment. However, since in addition to our study, several smaller studies have shown the reduction of urate depositions during ULT, [2][3][4][5][6] and given the strong recommendations to reduce serum urate levels in gout to a target, 7 8 a long-lasting RCT with a control group not treated according to current guidelines, at least in Scandinavia, seems not ethically acceptable to patients.…”