Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis

Pattamapaspong, Nuttaya; Vuthiwong, Withawat; Kanthawang, Thanat; Louthrenoo, Worawit

doi:10.1007/s00256-017-2611-z

Cited by 19 publications

(14 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Snowstorm appearance is suggestive of floating hyperechoic monosodium urate crystals or hyperechoic aggregation within the joint or along the tendons could indicate tophi [10]. Ultrasonography may help in the differential diagnosis of acute arthritis when special microscopic technical experience is not available [23].…”

Section: Discussionmentioning

confidence: 99%

The pattern of allopurinol prescription in a university hospital practice

Saad

Sabkar

2020

Egypt Rheumatol Rehabil

View full text Add to dashboard Cite

Background Allopurinol as a drug is commonly used to treat gout and its complications. The aim usually is to lower the level of serum uric acid. Also, it was found to be prescribed in cases of asymptomatic hyperuricemia. However, this medication has serious side effects and some of these are fatal. So the aim of the current research work is to look at its use, whether properly indicated or not, in a university hospital. Results A total of 427 patients were included in this study. Only 3.7% (16) of the patients had the drug for significant hyperuricemia. Gout was confirmed in 40 (9.4%) patients. Conclusion It is clear that most patients received allopurinol without proper indications. The inappropriate use of allopurinol should be looked at to reduce the cost of medication and more importantly to avoid possible adverse effects.

show abstract

Section: Discussionmentioning

confidence: 99%

The pattern of allopurinol prescription in a university hospital practice

Saad

Sabkar

2020

Egypt Rheumatol Rehabil

View full text Add to dashboard Cite

show abstract

“…Joint effusions in gout may range from simple, anechoic fluid to heterogeneous hyperechoic collection with synovitis ( Figure 7 a, Figure 8 b, Figure 9 , Figure 10 a,b and Figure 11 a) [ 17 , 28 , 65 ]. MSU crystal aggregates/microtophi can be seen in the joint as floating echogenic foci, known as the “snowstorm appearance” ( Figure 7 a) [ 7 , 9 , 13 , 15 , 17 , 18 , 28 , 29 , 31 , 36 , 59 , 65 , 66 , 67 ]. These echogenic foci could represent joint bodies, and US cannot differentiate MSU crystals from calcifications; DECT can be utilized for this [ 13 ].…”

Section: Imagingmentioning

confidence: 99%

“…MSU crystals also precipitate on the superficial layer of the hyaline cartilage, producing an irregular hyperechoic line over the anechoic cartilage. This hyperechoic line parallels the hyperechoic line of the subchondral bone, separated by anechoic cartilage, producing the “double contour sign” ( Figure 8 c and Figure 9 ) [ 7 , 9 , 13 , 15 , 17 , 18 , 29 , 31 , 36 , 46 , 57 , 59 , 65 , 66 , 67 ]. OMERACT defined the double contour sign as “abnormal hyperechoic band over the superficial margin of the articular hyaline cartilage, independent of the angle of insonation and which may be either irregular or regular, continuous or intermittent and can be distinguished from the cartilage interface sign” [ 63 ].…”

Section: Imagingmentioning

confidence: 99%

“…Gouty arthropathy occurs secondary to abnormal purine metabolism, the end product of which is uric acid, combined with underexcretion or overproduction of uric acid, resulting in sustained hyperuricemia. Hyperuricemia, above the local solubility, can lead to monosodium urate (MSU) crystal deposition ( Figure 1 ) in joints, on the surface of the hyaline cartilage and within periarticular soft tissues such as tendons, ligaments, retinacula, and bursae, with resulting inflammatory response [ 7 , 13 , 14 , 16 , 17 , 19 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Gout predominantly affects the peripheral joints, but the axial skeleton may also be affected [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging

Weaver

Vina

Munk

et al. 2021

JCM

View full text Add to dashboard Cite

Gout, a crystalline arthropathy caused by the deposition of monosodium urate crystals in the articular and periarticular soft tissues, is a frequent cause of painful arthropathy. Imaging has an important role in the initial evaluation as well as the treatment and follow up of gouty arthropathy. The imaging findings of gouty arthropathy on radiography, ultrasonography, computed tomography, dual energy computed tomography, and magnetic resonance imaging are described to include findings of the early, acute and chronic phases of gout. These findings include early monosodium urate deposits, osseous erosions, and tophi, which may involve periarticular tissues, tendons, and bursae. Treatment of gout includes non-steroidal anti-inflammatories, colchicine, glucocorticoids, interleukin-1 inhibitors, xanthine oxidase inhibitors, uricosuric drugs, and recombinant uricase. Imaging is critical in monitoring response to therapy; clinical management can be modulated based on imaging findings. This review article describes the current standard of care in imaging and treatment of gouty arthropathy.

show abstract

“…The pooled sensitivity and specificity of US were 65.1% (95% confidence interval [CI], 62.0∼68.2) and 89.0% (95% CI, 96.6∼91.1), respectively (Table 1, Figure 1). The PLR, NLR, and DOR were 5.889 (3.365∼10.30), 0.359 (0.266∼ 0.485), and 17.61 (11.11∼17.92), respectively (Table 2) [30][31][32][33][34][35][36][37][38][39][40]. The AUC of US was 0.858 and the Q* index was 0.789, indicating good diagnostic accuracy (Table 1, Figure 2).…”

Section: An Example Of a Meta-analysis Of Diagnostic Test Accuracymentioning

confidence: 99%

Overview of the Process of Conducting Meta-analyses of the Diagnostic Test Accuracy

Lee

2018

J Rheum Dis

View full text Add to dashboard Cite

Diagnosis is a critical step for clinical treatment. Many individual studies have been conducted to determine the accuracy of various diagnostic tests, but they had small sample sizes and correspondingly inadequate statistical strength. Combining the results from several such studies can help increase the statistical strength and precision of their results. Meta-analysis is a useful tool for evaluating the accuracy of diagnostic tests and can be used to obtain precise estimates when multiple small studies for a given test and subject pool are available. The need for meta-analysis on studies examining diagnostic test accuracy has increased noticeably, and more meta-analyses on diagnostic test accuracy studies are being published. A meta-analysis of diagnostic test accuracy studies differs from a typical meta-analysis because diagnostic test accuracy studies report a pair of statistics, such as sensitivity and specificity, rather than a single statistic. Therefore, meta-analyses of the diagnostic test accuracy need to deal with two summary statistics simultaneously. More complex statistical methods are required for conducting meta-analyses using diagnostic test accuracy studies compared to that required for conventional meta-analysis. This is because the sensitivity and specificity are generally inversely correlated due to a threshold effect, and there is considerable heterogeneity in the results of test accuracy studies. This review provides an overview of the process of meta-analysis of the diagnostic test accuracy. (J Rheum Dis 2018;25:3-10)

show abstract

Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis

Abstract: When the prevalence is high, these three ultrasound features may be a useful adjunct in the diagnosis of acute gout, particularly when specialized microscopic techniques are not available.

Cited by 19 publications

References 27 publications

The pattern of allopurinol prescription in a university hospital practice

The pattern of allopurinol prescription in a university hospital practice

Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging

Overview of the Process of Conducting Meta-analyses of the Diagnostic Test Accuracy

Contact Info

Product

Resources

About