Ultrasound features of tophi in chronic tophaceous gout

Fernandes, Eloy de Ávila; Kubota, Edson Shinji; Sandim, Gabriel Barbosa; Mitraud, Sônia A. V.; Ferrari, Antonio J. L.; Fernandes, Ana

doi:10.1007/s00256-010-1008-z

Cited by 72 publications

(28 citation statements)

References 26 publications

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“…The peripheral anechoic halo likely represents the fibrovascular zone [20] noted in histology, with a more central hyperechoic synovial proliferation. Sometimes the tophus can be ill defined, traversing multiple fascial planes.…”

Section: Ultrasoundmentioning

confidence: 99%

Imaging Appearances in Gout

et al. 2013

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Gout is an ancient disease. Last decade has brought about significant advancement in imaging technology and real scientific growth in the understanding of the pathophysiology of gout, leading to the availability of multiple effective noninvasive diagnostic imaging options for gout and treatment options fighting inflammation and controlling urate levels. Despite this, gout is still being sub-optimally treated, often by nonspecialists. Increased awareness of optimal treatment options and an increasing role of ultrasound and dual energy computed tomography (DECT) in the diagnosis and management of gout are expected to transform the management of gout and limit its morbidity. DECT gives an accurate assessment of the distribution of the deposited monosodium urate (MSU) crystals in gout and quantifies them. The presence of a combination of the ultrasound findings of an effusion, tophus, erosion and the double contour sign in conjunction with clinical presentation may be able to obviate the need for intervention and joint aspiration in a certain case population for the diagnosis of gout. The purpose of this paper is to review imaging appearances of gout and its clinical applications.

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Section: Ultrasoundmentioning

confidence: 99%

Imaging Appearances in Gout

et al. 2013

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“…The commonly seen surrounding hypoechoic 'halo' probably corresponds to the outer, loose fibrovascular zone seen on histology [16]. These authors detected 'dorsal shadowing' over cartilage surfaces causing partial reflection of the US wave.…”

Section: Joint Pathology In Goutmentioning

confidence: 99%

Imaging in gout - What can we learn from MRI, CT, DECT and US?

2011

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There are many exciting new applications for advanced imaging in gout. These modalities employ multiplanar imaging and allow computerized three-dimensional rendering of bone and joints (including tophi) and have the advantage of electronic data storage for later retrieval. High-resolution computed tomography has been particularly helpful in exploring the pathology of gout by investigating the relationship between bone erosions and tophi. Magnetic resonance imaging and ultrasonography can image the inflammatory nature of gouty arthropathy, revealing synovial and soft tissue inflammation, and can provide information about the composition and vascularity of tophi. Dual-energy computerized tomography is a new modality that is able to identify tophi by their chemical composition and reveal even small occult tophaceous deposits. All modalities are being investigated for their potential roles in diagnosis and could have important clinical applications in the patient for whom aspiration of monosodium urate crystals from the joint is not possible. Imaging can also provide outcome measures, such as change in tophus volume, for monitoring the response to urate-lowering therapy and this is an important application in the clinical trial setting.

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“…Tophi may exist as single lesions, but often are grouped, with poorly defined contours [10]. Tophi are frequently observed on ultrasonography in contact with or invading adjacent bone and joint structures [10]. A recent systematic literature review [19 & ] has examined the potential role for ultrasonography as a method to assess tophus size in clinical trials of chronic gout.…”

Section: Andandmentioning

confidence: 99%

“…1). Tophi may exist as single lesions, but often are grouped, with poorly defined contours [10]. Tophi are frequently observed on ultrasonography in contact with or invading adjacent bone and joint structures [10].…”

mentioning

confidence: 99%