Assessment of Tophus Size

Dalbeth, Nicola; Aati, Opetaia; Gao, Angela; House, Meaghan E; Liu, Qiliang; Horne, Anne; Doyle, Anthony; McQueen, Fiona

doi:10.1097/rhu.0b013e31823e5cda

Cited by 55 publications

(11 citation statements)

References 18 publications

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Section: Discussionsupporting

confidence: 71%

“…Dalbeth et al have shown that DECT deposits are scattered across the tophus and are surrounded by soft tissue [9], which is consistent with a previous histological analysis of tophi from the same team [23]. US measurements of tophi, like physical examination, provides an assessment of the overall tophaceous structure, soft tissue included [9]. It is probable that DECT provides a more accurate assessment of the crystal deposition itself within the tophus, regardless of the surrounding cellular organisation [24].…”

Section: Discussionmentioning

confidence: 99%

“…DECT uses two X-ray beams with two different energies, which allows a distinction between chemical entities, and in the case of gout discriminates urate from calcium [8]. DECT provides measurement of the volume of tophaceous and non-tophaceous soft tissue urate deposits with the limitation of spatial resolution [9]. So far, the sensitivity of DECT for urate deposits in soft tissues has been mainly used for diagnostic purposes [10].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

et al. 2017

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BackgroundUltrasonography (US) and dual-energy computed tomography (DECT) can assess urate burden in gout. The objective of this study was to compare the quantification of urate deposition provided by US to the one provided by DECT.MethodsPatients with a diagnosis of gout were prospectively recruited to undergo quantification of urate deposition using US and DECT. US examination for tophi and the double contour (DC) sign was performed on the knees and feet and corresponding DECT scans provided volumes of tophi and of overall urate deposition. The primary endpoint was the intra-class correlation coefficient (ICC) of the volume of the index tophus measured by US and DECT and its 95% confidence interval (CI 95%).ResultsOf the 64 patients included, 34 presented with at least one tophus on US. DECT inter-reader agreement for urate deposition was perfect with an ICC of 1 (1–1) and good for the measurement of the index tophus with an ICC of 0.69 (0.47–0.83). The ICC for the measurement of the index tophus between the two techniques was poor with a value of 0.45 (0.1–0.71). The average ratio between the index tophi volume as assessed by DECT and US was 0.65. The number of DC-positive joints did not correlate with DECT volume of overall deposits (Spearman correlation coefficient of 0.23).ConclusionsDECT measurements of tophi give smaller volumes to the same tophi measured with US, and US signs of urate deposition in joints do not correlate with overall DECT volumes of extra-articular deposition.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-017-1381-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

et al. 2017

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“…Gout also can manifest as chronic arthritis of one or more joints (1;2). Tophi, mainly in articular, periarticular, bursal, bone, auricular, and cutaneous tissues are a pathognomonic feature of gout, and are detectable by physical exam, and/or by imaging approaches and pathology examination (3;4;5). Renal manifestations of gout include urolithiasis, typically occurring with an acidic urine pH (1;2).…”

Section: Introductionmentioning

confidence: 99%

2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia

Khanna

Fitzgerald

Khanna

et al. 2012

Arthritis Care & Research

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1,390

1,382

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“…Subcutanous tophi duration, measured in years, was determined as the time period from subcutaneous tophus onset to initial visit. A visible subcutaneous tophus was measured according to its longest diameter using a Vernier caliper (11) ( Figure 1); this approach was endorsed as an index tophus measurement in the outcome of a rheumatology clinical trial (15). Intra-articular tophus was assessed by a radiologist, who did not know the clinical information and disease severity of the enrolled patients.…”

Section: Patientsmentioning

confidence: 99%

Limited Knee-Joint Range of Motion in Patients With Tophaceous Gout Improved With Medical Treatment: A 18-Months Follow Up

Wei

Chang

et al. 2020

Front. Med.

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Objectives: Tophi may occur within the knee joint causing limited knee-joint range of motion (knee motion). We investigated the relationships between knee motion, total intra-articular tophi size (tIA-tophi), and total subcutaneous tophi size (tSC-tophi) and determined knee motion improvement after continual urate-lowering therapy (ULT). Methods: A total of 26 patients with tophaceous gout and limited knee motion were enrolled. Inclusion criteria were age ≤60 years and preserved knee joint space on a plain radiograph. tSC-tophi were measured using a Vernier caliper and tIA-tophi were measured using magnetic resonance imaging software. All patients were re-evaluated after 12-24 months of continual ULT. Upon initial visit, knee motion was related to tIA-tophi and tSC-tophi. Results: After an average of 18.2 months of ULT, the reduction in tSC-tophi was correlated with the reduction in tIA-tophi (P = 0.014, r = 0.395) and improvement in knee motion (P = 0.038, r = 0.408). Knee motion can be eventually improved even in cases of poor initial knee motion (P = 0.000, r =-0.911) or large initial tIA-tophi (P = 0.014, r = 0.476). Tophi can occur in any location within the knee joint. In multiple lineal regression, knee motion was predicted to improve 8.39 • for every 10cm of tIA-tophi reduction. Conclusions: Limited knee motion in patients with intra-articular tophi improved with medical treatment, regardless of initial severity. Furthermore, tSC-tophi can be used as an indicator of limited knee motion and their improvement as a predictor of knee motion improvement.

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Assessment of Tophus Size

Abstract: Dual-energy computed tomography scanning is a highly reproducible method for measuring urate deposits within tophi. This imaging modality reveals the composition of tophi that contain variable urate deposits embedded within soft tissue.

Cited by 55 publications

References 18 publications

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia

Limited Knee-Joint Range of Motion in Patients With Tophaceous Gout Improved With Medical Treatment: A 18-Months Follow Up

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