Multiple Gouty Tophi with Bone Erosion and Destruction: A Report of an Early-onset Case in an Obese Patient

Hayashi, Reiko; Yamaoka, Mitsuaki; Nishizawa, Hitoshi; Fukuda, Shiro; Fujishima, Yuya; Kimura, Tsukasa; Kozawa, Jyunji; Kita, Satomi; Matsuoka, Taka‐aki; Otsuki, Michio; Imagawa, Akihisa; Ichida, Kimiyoshi; Taniguchi, Atsuo; Maeda, Norikazu; Funahashi, Tohru; Shimomura, Iichiro

doi:10.2169/internalmedicine.56.7923

Cited by 1 publication

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References 28 publications

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“…Tophi deposits are generally found at the 1st metatarsophalangeal (MTP) joints; however, they are occasionally found in the ankles and knees. Tophi has also been shown to promote chronic inflammation and erosive arthritis 3 . The gold standard for the diagnosis of gout is arthrocentesis 4 ; however, imaging is increasingly being used to confirm the diagnosis due to its noninvasiveness 5 .…”

Section: Introductionmentioning

confidence: 99%

Identification of tophi in ultrasound imaging based on transfer learning and clinical practice

Lin

Lee

Chang

et al. 2023

Sci Rep

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Gout is a common metabolic disorder characterized by deposits of monosodium urate monohydrate crystals (tophi) in soft tissue, triggering intense and acute arthritis with intolerable pain as well as articular and periarticular inflammation. Tophi can also promote chronic inflammatory and erosive arthritis. 2015 ACR/EULAR Gout Classification criteria include clinical, laboratory, and imaging findings, where cases of gout are indicated by a threshold score of ≥ 8. Some imaging-related findings, such as a double contour sign in ultrasound, urate in dual-energy computed tomography, or radiographic gout-related erosion, generate a score of up to 4. Clearly, the diagnosis of gout is largely assisted by imaging findings; however, dual-energy computed tomography is expensive and exposes the patient to high levels of radiation. Although musculoskeletal ultrasound is non-invasive and inexpensive, the reliability of the results depends on expert experience. In the current study, we applied transfer learning to train a convolutional neural network for the identification of tophi in ultrasound images. The accuracy of predictions varied with the convolutional neural network model, as follows: InceptionV3 (0.871 ± 0.020), ResNet101 (0.913 ± 0.015), and VGG19 (0.918 ± 0.020). The sensitivity was as follows: InceptionV3 (0.507 ± 0.060), ResNet101 (0.680 ± 0.056), and VGG19 (0.747 ± 0.056). The precision was as follows: InceptionV3 (0.767 ± 0.091), ResNet101 (0.863 ± 0.098), and VGG19 (0.825 ± 0.062). Our results demonstrate that it is possible to retrain deep convolutional neural networks to identify the patterns of tophi in ultrasound images with a high degree of accuracy.

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Section: Introductionmentioning

confidence: 99%