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

Sun, Chencheng; Qi, Xuan; Tian, Yu; Gao, Lixia; Jin, Hongtao; Guo, Haipeng

doi:10.1186/s13018-019-1280-0

Cited by 13 publications

(8 citation statements)

References 40 publications

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“…Previous studies have shown that age, duration of gout, and eGFR are risk factors for the development of US‐detected tophi and multiple subcutaneous tophi (36–38). This is consistent with our own finding of an association between age and duration of gout with the development of tophi, which remained significant after multivariable analysis.…”

Section: Discussionmentioning

confidence: 99%

Association of the Quantity, Duration, and Type of Alcohol Consumption on the Development of Gouty Tophi

Han

Lü

et al. 2022

Arthritis Care & Research

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Objective To examine the association of alcohol consumption with the presence and development of ultrasound (US)–detected tophi and subcutaneous tophi in a Chinese gout population. Methods A total of 554 patients with gout who underwent US and physical examination of the most frequently involved joints in gout were included in this study. Multivariable analysis was performed to assess the associations of the duration, quantity, and type of alcohol consumption with the presence, size, and number of US‐detected tophi and subcutaneous tophi. Results Compared to non‐drinkers, excessive drinkers (>70 gm/week), long‐term drinkers (≥10 years), and spirits drinkers had a greater proportion, size, and number of US‐detected tophi and subcutaneous tophi (all P < 0.05). After adjusting for confounders, excessive drinking (>70 gm/week) (odds ratio [OR] 1.79 [2.00 after adjustment]), long‐term alcohol consumption (≥10 years) (OR 1.96 [2.17 after adjustment]), and spirits consumption of (OR 1.81 [2.10 after adjustment]) were significantly associated with the presence of US‐detected tophi and subcutaneous tophi (all P < 0.05), with the highest ORs among the identified risk factors. Among patients who already had US‐detected tophi or subcutaneous tophi, moderate drinking (≤70 gm/week) was associated with larger or multiple tophi (all P < 0.05). Conclusion Longer duration and higher quantity of alcohol consumption as well as spirits consumption are predictors for the development of US‐detected tophi and subcutaneous tophi in patients with gout. Among individuals who have US‐detected tophi and subcutaneous tophi, weekly alcohol consumption leads to the development of tophi regardless of amount consumed.

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Section: Discussionmentioning

confidence: 99%

Association of the Quantity, Duration, and Type of Alcohol Consumption on the Development of Gouty Tophi

Han

Lü

et al. 2022

Arthritis Care & Research

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“…If the blood creatinine value is higher than the normal value, it indicates kidney damage; therefore, the blood CREA level can more accurately reflect renal parenchymal damage. 27,28 Our research found that the higher the CREA level, the higher the risk of renal cortex thinning in gout patients, suggesting that in the clinical diagnosis and treatment process, we could indirectly predict renal function impairment through the US changes in the renal cortex. In contrast, we could also use the blood CREA level to predict the related changes in the renal cortex indirectly.…”

Section: Discussionmentioning

confidence: 77%

Analysis of Risk Factors for Changes in the Renal Two-Dimensional Image in Gout Patients

Dang¹,

Xu²,

Luo³

et al. 2021

IJGM

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To explore the effects of different blood uric acid levels in gout patients on the twodimensional image of the kidney and the risk factors for gout-related kidney damage for providing clinical evidence to enable early prevention and treatment of gout-related kidney damage. Methods: We obtained information of 227 patients with primary gout and estimated the association between two-dimensional kidney images and clinical indicators using binary logistic regression. Results: Our study showed that different uric acid levels, age, disease course, cystatin C (CysC) level, and γ-glutamyl transpeptidase level were correlated with echo of the renal medulla (P < 0.05). CysC level was correlated with the renal cortex thickness and kidney stones in different uric acid-level groups (P < 0.05). Disease course, aspartate transaminase (AST) level, creatinine (CREA) level, and tophi were risk factors for renal cortex thinning in gout patients (P = 0.045, 0.026, 0.004, 0.006, respectively). The disease course, platelet (PLT) count, and high-density lipoprotein (HDL-C) level were risk factors for kidney stone formation in gout patients (P = 0.037, 0.022, 0.023, respectively), while CysC level and C-reactive protein (CRP) level were risk factors for increased renal medulla echo in these patients (P = 0.022, 0.028, respectively). Conclusion:Our study revealed disease course, AST level, CREA level, tophi, PLT count, HDL-C level, CysC level and CRP level may be important predictors of renal image changes.

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“…Deposition of monosodium urate crystals on the most superficial layer of hyaline cartilage results in "double contour sign" which is an irregular echogenic line demonstrated on ultrasonography and notably manifests during gout flare-up in patients with a prior history of gout attacks, and with asymptomatic hyperuricemia [5]. However, the sensitivity of these findings on ultrasonography ranges between 25% and 95% [6].…”

Section: Discussionmentioning

confidence: 99%

Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout

Reddy¹

2021

Dubai Med J

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Tophaceous gout is a crystal arthropathy and a disorder of purine metabolism characterized by monosodium urate crystal deposition. A case of tophaceous gout of the knee joint in a 30-year-old female is reported, and the imaging appearances on high-resolution ultrasonography are described. The patient presented with complaints of insidious onset painless swelling of the left knee joint with limitation of range of movement for 1 week. The aspirated joint fluid demonstrated needle-like monosodium urate crystals showing strong negative birefringence consistent with a diagnosis of tophaceous gout. Targeted urate-lowering treatment included oral nonsteroidal anti-inflammatory drugs and oral colchicine. Prophylactic treatment for gout flare-ups included initiation of allopurinol at 300 mg/day along with modification of the dietary regimen including limited consumption of red meat and increased consumption of low-fat dairy products. Symptomatic improvement with reduced pain and swelling of the knee joint was noted at 10 days after treatment. Subsequently, at 3-month follow-up, the patient was disease free with no signs of recurrence and serum uric acid levels at 3.7 mg/dL. In spite of a wide range of therapeutic options available for the management of tophaceous gout, suboptimal management of gout is prevalent till date in both developing and developed nations across the world.

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

Cited by 13 publications

References 40 publications

Association of the Quantity, Duration, and Type of Alcohol Consumption on the Development of Gouty Tophi

Association of the Quantity, Duration, and Type of Alcohol Consumption on the Development of Gouty Tophi

Analysis of Risk Factors for Changes in the Renal Two-Dimensional Image in Gout Patients

Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout

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