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

Singh, Jasvinder A.; Dalbeth, Nicola

doi:10.3899/jrheum.141322

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Based on those results, we speculated that there might be an US sensitivity for tophi and double-contour sign in MTP 1 joints. Furthermore, the double-contour sign might be the specific manifestation in knee joints and ankle joints, which was different from the results of Singh and Dalbeth [17]. The reason for this difference might be the larger sample size of knee and ankle joints enrolled in the present study.…”

Section: Discussioncontrasting

confidence: 88%

“…Pineda et al showed that the double-contour sign was found in almost 25% of MTP 1 joints (higher than any other kinds of joints) of gout patients [37]. Previous studies indicate that the double-contour sign and tophi are the two classical manifestations of urate deposition in joints of gout patients [16, 17, 38]. However, based on a meta-analysis of the diagnostic accuracy for US, Young et al showed that US signs of tophi and the double-contour sign were not sensitive in gout patients [39].…”

Section: Discussionmentioning

confidence: 99%

“…However, based on a meta-analysis of the diagnostic accuracy for US, Young et al showed that US signs of tophi and the double-contour sign were not sensitive in gout patients [39]. Singh and Dalbeth even doubt that the double-contour sign was not specific for gout but for calcium pyrophosphate crystal deposition or other arthritis [17]. Thus, although US is optimal tool for urate deposition monitoring, the US diagnostic sensitivity and specificity for tophi and the double-contour sign in gout patients is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the US detection, the joint and tendon subclinical involvement are proved to be risk factors of gouty arthritis [15]. US double-contour sign is a specific manifestation of urate deposition in gouty arthritis [16, 17]. The American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR)-gout have already clarified the association between US and double-contour sign [18].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for the formation of double-contour sign and tophi in gout

Sun

Tian

et al. 2019

J Orthop Surg Res

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Background This study aimed to confirm the diagnostic accuracy of ultrasound (US) on gout and explore the potential risk factors for double-contour sign and tophi formation in gout patients. Methods The US analyses were performed on all knee, ankle, and first metatarsophalangeal (MTP 1) joints to reveal the type and location of lesions. While a questionnaire and blood biochemical index were used to explore the potential risk factors for double-contour sign and tophi in gout, the SPSS17.0 software was used for statistical analysis in the present study. Results Totally, 117 gout patients with 702 joints (38 lesions in knee joint, 93 lesions in ankle joint, and 112 lesions in MTP 1 joint) were enrolled in current analyses. Double-contour sign and joint effusion were the two most outstanding lesion manifestations in knee joints and ankle joints. Tophi and double-contour sign were the two most outstanding lesion manifestations in TMP 1 joints. Moreover, factors including uric acid (UA) level and the highest blood UA were potential risk factors of the double-contour sign, while age and history of US were potential risk factors for tophi. Conclusion US was effective on the joints of gout patients. There was US sensitivity for tophi and double-contour sign in MTP 1 joints. The double-contour sign was a potential specific manifestation in knee joints and ankle joints. Furthermore, UA and highest blood UA level were potential risk factors for double-contour sign, while age and US history were potential risk factors for tophi.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for the formation of double-contour sign and tophi in gout

Sun

Tian

et al. 2019

J Orthop Surg Res

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“…The attenuation of urate differs significantly from that of bone, depending on the kilovolt setting of the X-ray tube. However, other crystalline diseases, such as calcium pyrophosphate deposition, can lead to an ultrasound appearance of double contour similar to that of gout [17]; therefore, it is now arguable whether double contour is specific for gout or for crystalline arthritis [18]. These modalities are providing insights into a better understanding of disease pathology and pathophysiology.…”

Section: Editorialmentioning

confidence: 99%

Gout: will the “King of Diseases” be the first rheumatic disease to be cured?

Singh

2016

BMC Med

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Gout is the most common inflammatory arthritis in adults in the Western world. Characterized by hyperuricemia and the effects of acute and chronic inflammation in joints and bursa, gout leads to an agonizing, chronically painful arthritis. Arthritis can also be accompanied by urate nephropathy and subcutaneous urate deposits (tophi). Exciting new developments in the last decade have brought back the focus on this interesting, crystal-induced chronic inflammatory condition. New insights include the role of NALP3 inflammasome-induced inflammation in acute gout, the characterization of diagnostic signs on ultrasound and dual-energy computed tomography imaging modalities, the recognition of target serum urate less than 6 mg/day as the goal for urate-lowering therapies, and evidence-based treatment guidelines. A better understanding of disease mechanisms has enabled drug discovery – three new urate-lowering drugs have been approved in the last decade, with several more in the pipeline. We now recognize the important role that environment and genetics play in the causation of gout. A focus on the cardiac, renal, and metabolic comorbidities of gout will help translational research and discovery over the next decade.

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