Diagnosis of gout by ultrasound

Thiele, Ralf; Schlesinger, Naomi

doi:10.1093/rheumatology/kem058

Cited by 324 publications

(203 citation statements)

References 22 publications

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“…Prior to scanning, examiners reviewed standardized definitions for MSUS structural abnormalities (e.g., enthesopathy, synovial proliferation, joint erosion, etc.) (11)(12)(13)(14)(15).…”

Section: Methodsmentioning

confidence: 99%

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Kissin¹,

Nishio²,

Yang³

et al. 2010

Arthritis Care & Research

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Objective. Because musculoskeletal ultrasound (MSUS) is highly user dependent, we aimed to establish whether non-mentored learning of MSUS is sufficient to achieve the same level of diagnostic accuracy and scanning reliability as has been achieved by rheumatologists recognized as international experts in MSUS. Methods. A group of 8 rheumatologists with more experience in MSUS and 8 rheumatologists with less experience in MSUS participated in an MSUS exercise to assess patients with musculoskeletal abnormalities commonly seen in a rheumatology practice. Patients' established diagnoses were obtained from chart review (gout, osteoarthritis, rotator cuff syndrome, rheumatoid arthritis, and seronegative arthritis). Two examining groups were formed, each composed of 4 less experienced and 4 more experienced examiners. Each group scanned 1 predefined body region (hand, wrist, elbow, shoulder, knee, or ankle) in each of 8 patients, blinded to medical history and physical examination. Structural abnormalities were noted with dichotomous answers, and an open-ended answer was used for the final diagnosis. Results. Less experienced and more experienced examiners achieved the same diagnostic accuracy (US-established diagnosis versus chart review diagnosis). The interrater reliability for tissue pathology was slightly higher for more experienced versus less experienced examiners ( ‫؍‬ 0.43 versus ‫؍‬ 0.34; P ‫؍‬ 0.001). Conclusion. Non-mentored training in MSUS can lead to the achievement of diagnostic accuracy in MSUS comparable to that achieved by highly experienced international experts. Reliability may increase slightly with additional experience. Further study is needed to determine the minimal training requirement to achieve proficiency in MSUS.

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“…Prior to scanning, examiners reviewed standardized definitions for MSUS structural abnormalities (e.g., enthesopathy, synovial proliferation, joint erosion, etc.) (11)(12)(13)(14)(15).…”

Section: Methodsmentioning

confidence: 99%

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Kissin¹,

Nishio²,

Yang³

et al. 2010

Arthritis Care & Research

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“…In previous US publications, the differential cartilage appearances of monosodium urate (MSU) and CPPD have been elegantly described, with MSU crystals overlying the articular cartilage leading to the DC sign in gout, and CPP crystals deposited within articular cartilage with a different appearance 2,3,4 . Of note, the study by Löffler and colleagues considered only the presence of DC sign and Doppler flow, but not tophi or fibrocartilage pathology, which may explain the low accuracy of US findings.…”

Section: Is the Double Contour Sign Specific For Gout? Or Only For Crmentioning

confidence: 99%

Is the Double Contour Sign Specific for Gout? Or Only for Crystal Arthritis?

Singh

Dalbeth

2015

J Rheumatol

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“…Ultrasonography (US) instead, can be used for diagnosis and management of gout from the first attack. Crystalline material found in gouty joints reflects ultrasound waves more strongly than surrounding tissues (such as un-mineralized hyaline cartilage or synovial fluid) and can thus be readily distinguished [11].…”

Section: Stage Symptomatology Definitionmentioning

confidence: 99%

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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Diagnosis of gout by ultrasound

Abstract: US can detect deposition of MSU crystals on cartilaginous surfaces (P < 0.001) as well as tophaceous material and typical erosions. US may serve as a non-invasive means to diagnose gout.

Cited by 324 publications

References 22 publications

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Self‐directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States

Is the Double Contour Sign Specific for Gout? Or Only for Crystal Arthritis?

The place of musculoskeletal ultrasonography in gout diagnosis

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