“Crystal Clear”—Sonographic Assessment of Gout and Calcium Pyrophosphate Deposition Disease

Grassi, Walter; Meenagh, G; Pascual, Eliseo; Filippucci, Emilio

doi:10.1016/j.semarthrit.2006.08.001

Cited by 202 publications

(154 citation statements)

References 14 publications

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“…Prior to scanning, examiners reviewed standardized definitions for MSUS structural abnormalities (e.g., enthesopathy, synovial proliferation, joint erosion, etc.) (11)(12)(13)(14)(15).…”

Section: Methodsmentioning

confidence: 99%

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Kissin¹,

Nishio²,

Yang³

et al. 2010

Arthritis Care & Research

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Objective. Because musculoskeletal ultrasound (MSUS) is highly user dependent, we aimed to establish whether non-mentored learning of MSUS is sufficient to achieve the same level of diagnostic accuracy and scanning reliability as has been achieved by rheumatologists recognized as international experts in MSUS. Methods. A group of 8 rheumatologists with more experience in MSUS and 8 rheumatologists with less experience in MSUS participated in an MSUS exercise to assess patients with musculoskeletal abnormalities commonly seen in a rheumatology practice. Patients' established diagnoses were obtained from chart review (gout, osteoarthritis, rotator cuff syndrome, rheumatoid arthritis, and seronegative arthritis). Two examining groups were formed, each composed of 4 less experienced and 4 more experienced examiners. Each group scanned 1 predefined body region (hand, wrist, elbow, shoulder, knee, or ankle) in each of 8 patients, blinded to medical history and physical examination. Structural abnormalities were noted with dichotomous answers, and an open-ended answer was used for the final diagnosis. Results. Less experienced and more experienced examiners achieved the same diagnostic accuracy (US-established diagnosis versus chart review diagnosis). The interrater reliability for tissue pathology was slightly higher for more experienced versus less experienced examiners ( ‫؍‬ 0.43 versus ‫؍‬ 0.34; P ‫؍‬ 0.001). Conclusion. Non-mentored training in MSUS can lead to the achievement of diagnostic accuracy in MSUS comparable to that achieved by highly experienced international experts. Reliability may increase slightly with additional experience. Further study is needed to determine the minimal training requirement to achieve proficiency in MSUS.

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“…Prior to scanning, examiners reviewed standardized definitions for MSUS structural abnormalities (e.g., enthesopathy, synovial proliferation, joint erosion, etc.) (11)(12)(13)(14)(15).…”

Section: Methodsmentioning

confidence: 99%

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Kissin¹,

Nishio²,

Yang³

et al. 2010

Arthritis Care & Research

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“…In previous US publications, the differential cartilage appearances of monosodium urate (MSU) and CPPD have been elegantly described, with MSU crystals overlying the articular cartilage leading to the DC sign in gout, and CPP crystals deposited within articular cartilage with a different appearance 2,3,4 . Of note, the study by Löffler and colleagues considered only the presence of DC sign and Doppler flow, but not tophi or fibrocartilage pathology, which may explain the low accuracy of US findings.…”

Section: Is the Double Contour Sign Specific For Gout? Or Only For Crmentioning

confidence: 99%

Is the Double Contour Sign Specific for Gout? Or Only for Crystal Arthritis?

Singh

Dalbeth

2015

J Rheumatol

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“…Deposition of MSU crystals on the hyaline cartilage surface leads to hyperechoic enhancement of the superficial margin of the cartilage layer (29). Tophi appear as nodular deposits; the most frequent locations are the fingers, toes, and olecranon bursae.…”

Section: Goutmentioning

confidence: 99%

“…US is more sensitive than conventional radiography in detecting pyrophosphate crystals (35). In CPPD, hyperechoic crystals form a thin linear band within the anechoic articular cartilage, especially in the Achilles tendons or plantar fascia (29,36), and hyperechoic rounded areas in fibrocartilage, typically in the triangular ligament of the wrist and in the menisci of the knee (29,35). Acoustic shadowing is absent behind the calcifications in CPPD (37).…”

Section: Goutmentioning

confidence: 99%

Doppler US in rheumatic diseases with special emphasis on rheumatoid arthritis and spondyloarthritis

Toprak

Kılıç

Serter³

et al. 2013

Diagn Interv Radiol

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Developments in digital ultrasonography (US) technology and the use of high-frequency broadband transducers have increased the quality of US imaging, particularly of superficial tissues. Thus, US, particularly color US or power Doppler US, in which high-resolution transducers are used, has become an important imaging modality in the assessment of rheumatic diseases. Furthermore, therapeutic interventions and biopsies can be performed under US guidance during the assessment of lesions. In this era of effective treatments, such as biologics, improvements in synovial inflammation in rheumatoid arthritis as well as changes in enthesitis in spondyloarthropathies, including ankylosing spondylitis and psoriatic arthritis, can be monitored effectively using gray-scale and/ or power Doppler US. US is also a good imaging modality for crystal arthropathies, including gout and pseudogout, in which synovitis, erosions, tophi, and crystal deposition within or around the joint can be visualized readily. Vascular and tenosynovial structures, as well as the salivary glands, can be assessed with US in vasculitis and connective tissue disorders, including systemic lupus erythematosus and Sjögren's syndrome. Current research is focused on improving the sensitivity, specificity, validity, and reproducibility of US findings. In this review, we summarized the role of US, particularly power Doppler US, in rheumatic diseases and inflammation in superficial tissues.

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“Crystal Clear”—Sonographic Assessment of Gout and Calcium Pyrophosphate Deposition Disease

Cited by 202 publications

References 14 publications

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Is the Double Contour Sign Specific for Gout? Or Only for Crystal Arthritis?

Doppler US in rheumatic diseases with special emphasis on rheumatoid arthritis and spondyloarthritis

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