An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs

Carter, John D.; Kedar, R P; Anderson, Scott R.; Osorio, Angie H; Albritton, Nancy L; Gnanashanmugam, Shanmugapriya; Valeriano, Joanne; Vasey, Frank B.; Ricca, Louis

doi:10.1093/rheumatology/kep278

Cited by 104 publications

(67 citation statements)

References 15 publications

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“…36 Metabolic/endocrine lesions Tissue Deposition of uric acid or hydroxyapatite crystals in the gout or connective tissue disorders are associated with BML. 37,38 Latrogenic lesions Damage to the bone marrow by surgery or radiotherapy also causes BML. Also, the use of corticosteroids, other immunosuppressive therapies and cytostatics have been implicated.…”

Section: Infectious Lesionsmentioning

confidence: 99%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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Bone marrow lesions (BMLs) or using older terminology 'Bone marrow edema' is characterised by excessive water signals in the marrow space on magnetic resonance imaging or ultrasound; BMLs constitute a central component of a wide variety of inflammatory and non-inflammatory rheumatologic conditions affecting the musculoskeletal system: BMLs are not only considered significant sources of pain but also linked to increased disease activity in many musculoskeletal conditions (for example, osteoarthritis, rheumatoid arthritis). The purpose of this review is to summarise current knowledge about the treatment of BMLs, with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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Section: Infectious Lesionsmentioning

confidence: 99%

Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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“…A large percentage of patients with gout and normal plain radiographs have destructive arthropathy that is only detected by MRI, which seems more sensitive than US [61,62].…”

Section: Metabolic/endocrine Lesionsmentioning

confidence: 99%

Bone marrow lesions: a universal bone response to injury?

Eriksen

Ringe

2011

Rheumatol Int

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The ever increasing use of magnetic resonance imaging in clinical practice has led to the recognition of a new entity, bone marrow lesions (BMLs). These lesions are characterized by excessive water signals in the marrow space and have emerged as a central component of many different diseases affecting the musculoskeletal system. BMLs have in particular been associated with a wide variety of inflammatory and non-inflammatory rheumatologic conditions and are not only considered significant sources of pain, but also linked to the worsening of patient prognosis in many disease states. In this review, we summarize the current knowledge on BMLs with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease and provide a unifying hypothesis based on the appearance with various imaging technologies. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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“…The sensitivity of MRI to change of tophi over time is not established. Compared with US, MRI is more sensitive in detecting gouty changes if US transducer frequencies lower than 10 MHz are used [16], and less sensitive than US if transducer frequencies higher than 13 MHz are used [5].…”

Section: Mrimentioning

confidence: 99%

Role of Ultrasound and Other Advanced Imaging in the Diagnosis and Management of Gout

Thiele

2011

Curr Rheumatol Rep

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Imaging of gout with conventional radiography has been described since shortly after roentgenography was invented. Ultrasound (US) detects more erosions than conventional radiography in rheumatoid arthritis, and the same seems to be true for gout. MRI is being used to assess articular and periarticular masses, including gouty tophi. However, MRI findings in gout can lack specificity. Monosodium urate (MSU) tophi are very echogenic when US is used. Typical US features of gout include a double-contour sign or "urate icing." The double-contour consists of the hyperechoic bony contour and a parallel hyperechoic line of MSU crystals that deposit on the hypoechoic or anechoic hyaline cartilage. Tophi can have a "wet clumps of sugar" appearance, often surrounded by an anechoic halo. Tophi are closely related to the formation of erosions. If serum urate levels are lowered consistently below 6.0 mg/dL, the disappearance of MSU crystals can be observed sonographically.

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An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs

Abstract: A large percentage of patients with gout and normal plain radiographs have occult destructive arthropathy that is only detected by advanced imaging such as MRI and/or US. However, MRI appears to be much more sensitive than US at detecting these findings.

Cited by 104 publications

References 15 publications

Treatment of bone marrow lesions (bone marrow edema)

Treatment of bone marrow lesions (bone marrow edema)

Bone marrow lesions: a universal bone response to injury?

Role of Ultrasound and Other Advanced Imaging in the Diagnosis and Management of Gout

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