Systematic Review of the Value of Ultrasound and Magnetic Resonance Musculoskeletal Imaging in the Evaluation of Response to Treatment of Gout

Villaverde, Virginia; Rosario, María Piedad; Loza, Estíbaliz; Pérez, Fernando

doi:10.1016/j.reumae.2013.07.002

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…They are present in the late stage of the disease and their presence correlates directly with the number of acute attacks, duration of disease, and presence of tophi. Characteristic sites for erosions are represented by the medial aspect of the first metatarsophalangeal joint, that is the most frequent, and the metacarpophalangeal joints [37,38]. Gout erosions cannot be differentiated from other erosive inflammatory arthropathies and no specific scoring systems, different from those used in RA, have been reported [32,39].…”

Section: Us Findings In Goutmentioning

confidence: 99%

Musculoskeletal ultrasonography in gout

et al. 2015

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Gout is a frequent inflammatory disease induced by the deposition of monosodium urate crystals in joints and extraarticular tissues. The natural history of the disease includes four different phases: asymptomatic hyperuricemia, acute attacks, intercritical phase, and chronic tophaceous gout. Imaging techniques have several applications in the diagnosis, clinical monitoring and management of the disease but, particularly, musculoskeletal ultrasound is able to detect a wide set of abnormalities in gout. This review reports the most relevant findings detectable by ultrasound and the current available data in the literature regarding the role of musculoskeletal ultrasound in gout.

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Section: Us Findings In Goutmentioning

confidence: 99%

Musculoskeletal ultrasonography in gout

et al. 2015

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“…The pathological vascularisation can be detected also in apparently non-affected joints, demonstrating that power Doppler is significantly more sensitive in identification of the active gouty joints that is the clinical examination [22]. The main utility of US from this point of view seems to be the monitoring of the treatment in gouty patients [25].…”

Section: Synovial Hypertrophymentioning

confidence: 99%

“…Common sites for searching the bone erosions in patients with gout are the medial side of the first metatarsophalangeal (MTP) joint and the metacarpophalangeal (MCP) joints [12,18,25]. The erosions in gout detected by US at the MTP-1 are significantly more frequent (67%) comparing with other arthritis (43%) or healthy subjects (6%) [26].…”

Section: Bone Erosionsmentioning

confidence: 99%

“…Comparing US with x-ray findings, the erosions suggestive for gout are detected more often by US [25,26] proven to be a moderately specific (69%) but with a low sensitivity imaging method (24%) [27]. The main limitation of the method are the lack of clear criteria for differentiation the gout erosions from erosions of other inflammatory arthritis (RA, spondyloarthritis, etc).…”

Section: Bone Erosionsmentioning

confidence: 99%

“…Hyperechoic cloudy areas (HCA) or "cottony images" [25] are aggregates less then 1cm, well or poorly definite, generally homogeneous without posterior acoustic shadow [39] and are considered to be elementary lesions in gout [35]. HCA were found to be significantly influenced by treatment [35].…”

Section: Msu Aggregates (Hyperechoic Spots Hyperechoic Cloudy Areasmentioning

confidence: 99%

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The place of musculoskeletal ultrasonography in gout diagnosis

Fodor

Nestorova²,

Vlad

et al. 2014

Med Ultrason

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Gout represents a common inflammatory arthritis conditions in which the monosodium urate (MSU) crystals are deposited in joints and other tissues producing attacks of acute arthritis/ chronic arthropathy with important destructive lesions in articular or juxta-articular spaces.High resolution ultrasonography (US) is able to detect these deposits and their consequences: hyaline cartilage pathology, joint effusions, synovitis, bone erosions, tendonitis, bursitis, and other soft tissues involvement. Moreover, there are characteristic findings of this aggregates that can be detected by US, helping the clinician for positive and differential diagnosis. In this review we will present the main US findings in gout. The utility of the method in diagnosis and treatment response will be discussed. Also, comparison with other imaging techniques in terms of sensibility and specificity of the methods for this pathological situation will be made.

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A descriptive, cross-sectional study characterizing bone erosions in rheumatoid arthritis and gout by ultrasound

et al. 2016

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The aim of this study is to characterize bone erosions in metatarsal heads (MTH) in rheumatoid arthritis (RA) and gout by grayscale ultrasound. In a descriptive, cross-sectional study, we evaluated 40 patients with RA and 40 with gout, both diagnosed according to the American College of Rheumatology/European League Against Rheumatism criteria, respectively. All patients had bone erosion demonstrated by ultrasound, which was used, following OMERACT criteria, to describe the shape, size, number, border definition, overhanging margin, topography (intra- or extra-articular), and distribution (over dorsal, medial, lateral, or plantar aspect) of the lesions in the MTH. Descriptive statistics were used and a concordance exercise between two ultrasonographers blinded to the diagnosis was performed. Bone erosions in RA were observed most frequently at the plantar and lateral aspect of the fifth MTH, round in 96 %, small-sized (2.43 ± 0.9 mm), intra-articular (100 %), and single (75 %). Few bone erosions had a well-defined border an overhanging margin while in gout were found most frequently in the medial and dorsal aspect of the first MTH, single in 71 %, intra-articular in 100 %, and of median size (4.0 ± 2.3). For shape, 51 % was round and 49 % was oval. A well-defined border was present in 39 %, and an overhanging margin in 62 %. Inter-rater reliability kappa was excellent (0.81, 95 % CI 0.56-1.00). Some characteristics of bone erosions in RA, including shape, size, ill-defined border, and localization in the fifth MTH could distinguish the lesions from gout. Grayscale US has excellent reliability to describe bone erosions in RA and gout.

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Systematic Review of the Value of Ultrasound and Magnetic Resonance Musculoskeletal Imaging in the Evaluation of Response to Treatment of Gout

Cited by 10 publications

References 13 publications

Musculoskeletal ultrasonography in gout

Musculoskeletal ultrasonography in gout

The place of musculoskeletal ultrasonography in gout diagnosis

A descriptive, cross-sectional study characterizing bone erosions in rheumatoid arthritis and gout by ultrasound

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