Unusual Manifestations of Gout

Wright, J. T.

doi:10.1111/j.1440-1673.1966.tb00826.x

Cited by 17 publications

(2 citation statements)

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“…The initial changes in joints are similar to the marginal joint erosion seen in rheumatoid arthritis, but the findings are differentiated by no joint narrow space and subchondral osteoporosis. In cases where gout has progressed, the disease presents with a punched-out lesion and "overhang," in which periosteal stimulation reveals eave-like projections along with joint destruction (6). When lesions cannot be detected by X-ray, a CT scan can be ef-fective.…”

Section: Discussionmentioning

confidence: 99%

Tophaceous Gout in the Cervical Spine

et al. 2012

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A 58-year-old woman with a three-year progressive history of chronic arthritis, had become disabled due to general malaise and fever. Her laboratory data revealed hyperuricemia and elevated levels of C-reactive protein. Neither rheumatoid factor nor anti-citrullinated peptide antibodies were present. We diagnosed her with tophaceous gout with uric crystalline revealed by the arthrocentesis of the elbow. 99m Tc scintigraphy also disclosed a significant uptake in the cervical spine. The CT of the patient's cervical spine revealed significant bone erosion and destruction. We diagnosed the cervical involvement of gout based on the exclusion of infections and sarcoidosis. Rheumatologists should be aware of this rare association.

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Section: Discussionmentioning

confidence: 99%

Tophaceous Gout in the Cervical Spine

et al. 2012

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“…These destructive changes are frequently associated with early degenerative osteoarthritis (OA) 25. With very advanced gout, more bizarre features can occur with bone loss, described by Wright et al as ‘vanishing bones’,26 and ossification of tophi. New bone formation also seems to be a radiographic feature of longstanding tophaceous gout and regions of bone sclerosis often occur adjacent to erosions or within their overhanging margins 20.…”

Section: Radiographymentioning

confidence: 99%

New insights into an old disease: advanced imaging in the diagnosis and management of gout

McQueen

Reeves

Dalbeth

2012

Postgraduate Medical Journal

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Advanced imaging modalities including MRI, ultrasound (US), CT and dual energy CT have important applications in gout. While conventional radiography (X-ray) remains the most widely used form of imaging in the clinical setting and is helpful in revealing erosions in chronic gout, these new imaging tools can reveal joint damage and tophi at a much earlier stage. As all are multiplanar techniques, they can define the position and dimensions of tophi, with startling clarity, as well as the size and extent of bone erosions. US and MRI also reveal the severity of inflammation within and adjacent to the joint and can capture information about the composite, vascular nature of many tophaceous deposits. These features can be used as imaging outcome measures, to monitor responses to anti-inflammatory and urate lowering therapies. The new possibility that gout could be diagnosed using imaging, without aspirating the joint, is on the horizon. This review discusses the clinical and research applications of advanced imaging in gout with particular focus on diagnosis and monitoring of joint inflammation and damage.

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