Imaging techniques can identify the core features of disease in gout: urate crystal deposition, joint inflammation and structural damage. Clinical applications include detection and measurement of urate crystal deposition using high resolution ultrasonography (US) and dual energy computed tomography (DECT), assessment of disease severity to guide treatment decisions, and detection of disease complications (eg. structural damage, tendon disease, concomitant infection). Although imaging modalities such as US and DECT are increasingly used for gout diagnosis in clinical practice, there are uncertainties about interpretation of results in asymptomatic hyperuricaemia, the sensitivity of these methods in early disease, artefact issues, and reliability. Imaging techniques also have potential to assess response to treatment, both in clinical practice and in research settings. Key questions remain about the sensitivity to change of urate crystal deposition, inflammation and joint damage using imaging techniques. Imaging techniques that allow visualisation of urate crystal deposition may play a particularly important role in patient understanding of disease and promoting engagement with long-term urate-lowering treatments.
Disclosure of Interest None declared