MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack

Cimmino, Marco A.; Zampogna, Giuseppe; Parodi, Monica; Andracco, R.; Barbieri, Francesca; Paparo, Francesco; Ferrero, Giulio; Garlaschi, Giacomo

doi:10.1136/ard.2011.153353

Cited by 26 publications

(14 citation statements)

References 7 publications

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“…Synovitis is common in patients with chronic gout. Synovitis was detected by MRI in 26 of 40 gout patients , and all 8 of the patients with acute gout developed wrist synovitis . We also investigated the association between synovial hypertrophy and erosions and found that bone sites affected by erosion were 1.87‐fold more likely to lie adjacent to regions of synovial hypertrophy than not to lie adjacent.…”

Section: Discussionmentioning

confidence: 97%

Prevalence and Factors Associated With Bone Erosion in Patients With Gout

Liu

Chen

et al. 2019

Arthritis Care & Research

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Objective. To determine the prevalence, distribution, and factors associated with bone erosion detectable by ultrasound in patients with gout.Methods. Ultrasound scans were performed in 980 patients with gout, and bone erosion was detected. The prevalence and distribution of bone erosion in gout patients were calculated. Both clinical variables and ultrasound signs were entered into a multivariate logistic regression analysis to clarify the factors associated with bone erosion in patients with gout.Results. Bone erosion was found in 431 (44.0%) of the 980 patients with gout, and in 338 (78.4%) of these patients, the bone erosion was found in the first metatarsophalangeal (MTP) joint. A multivariable logistic regression analysis showed that age, duration of gout, the existence of tophi, ultrasound-detected synovial hypertrophy, and joint effusion were independently associated with bone erosion. A tophus was the most powerful factor associated with bone erosion, with an odds ratio (OR) of 4.218 (95% confidence interval 3.092-5.731). The risk for bone erosion also increased as the number of tophi increased (P < 0.001). However, after stratifying the size of tophi, the ORs did not increase significantly (P = 0.206).Conclusion. A high percentage of gout patients had bone erosions; the first MTP joint was the most frequently involved site. Age, duration of gout, tophi, and synovial hypertrophy were factors associated with bone erosion in gout patients. The number of tophi, but not their size, was strongly associated with bone erosion in patients with gout.

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Section: Discussionmentioning

confidence: 97%

Prevalence and Factors Associated With Bone Erosion in Patients With Gout

Liu

Chen

et al. 2019

Arthritis Care & Research

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“…However, limitations include high cost, availability, long scanning time, use of contrast, patient acceptability, and exclusion of those patients with aneurysm clips or pacemaker. MRI can demonstrate generic features of inflammatory arthritis, such as synovial thickening, effusion, bone erosions, and bone marrow edema (BME) in gout [Popp et al 1996;Cimmino et al 2011] ( Figures 7 and 8). MRI can demonstrate subclinical inflammation in asymptomatic joints in gout [Carter et al 2009].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging in gout: A review of the recent developments

Chowalloor

Siew

Keen

2014

Therapeutic Advances in Musculoskeletal

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Gout is a common inflammatory arthritis and is caused by accumulation of monosodium urate crystals in joints and soft tissues. Apart from joint damage, untreated gout is associated with cardiovascular and renal morbidity. Gout, whilst in principle considered to be well understood and simple to treat, often presents diagnostic and management challenges, with evidence to suggest that it is often inadequately treated and poor compliance is a major issue. Imaging tools can aid clinicians in establishing the correct diagnosis, when histological crystal diagnosis is unable to be established, and also assess the burden of inflammatory and structural disease. Imaging can also be used to monitor treatment response. The imaging techniques that currently have a role in the imaging of gout include conventional radiography, ultrasound, computed tomography, dual energy computed tomography, magnetic resonance imaging and nuclear medicine. Despite the lack of major technological advances in imaging of gout in recent years, scientific studies of existing imaging modalities have improved our understanding of the disease, and how to best utilize imaging techniques in the clinical setting.

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“…High field MRI scanning can also be used to assess cartilage damage in RA, and validated scoring systems have been devised by ourselves and others . However, there is only a small amount of literature on the MRI features of gouty arthropathy . We reported data from a 10‐year retrospective study studying New Zealand patients with severe tophaceous gout .…”

Section: Introductionmentioning

confidence: 99%

A comparative MRI study of cartilage damage in gout versus rheumatoid arthritis

et al. 2015

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Cartilage damage is less severe in gout than in RA, with fewer sites affected and lower overall scores. It is associated with synovitis in both diseases, likely indicating an effect of pro-inflammatory cytokine production on cartilage integrity. However, the strong association between cartilage damage and BME observed in RA was not identified in gout. This emphasizes differences in the underlying pathophysiology of joint damage in these two conditions.

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MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack

Cited by 26 publications

References 7 publications

Prevalence and Factors Associated With Bone Erosion in Patients With Gout

Prevalence and Factors Associated With Bone Erosion in Patients With Gout

Imaging in gout: A review of the recent developments

A comparative MRI study of cartilage damage in gout versus rheumatoid arthritis

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