Gout is a chronic disease of monosodium urate (MSU) crystal deposition. A variety of measurement techniques are used to assess the burden of MSU crystal deposition, including physical measurement and advanced imaging methods. Recent imaging studies, particularly using ultrasonography (US) and dual energy computed tomography (DECT), have demonstrated the extent and patterns of MSU crystal deposition in a way that is not appreciated by physical examination alone. In particular, the close proximity of MSU crystals with articular cartilage is clearly visualised as the double contour sign on US. The frequent involvement of tendons can also be visualised using these imaging techniques. The close relationship between structural joint disease and MSU crystals visualised by DECT provides further rationale for effective urate-lowering therapy in people with gout.
Disclosure of Interest N. Dalbeth Consultant for: AstraZeneca, Takeda, Conflict with: Savient, Menorini