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MRI synovitis and bone lesions are common in acute gouty arthritis of the wrist even during the first attack
  1. M A Cimmino1,
  2. G Zampogna1,
  3. M Parodi1,
  4. R Andracco1,
  5. F Barbieri1,
  6. F Paparo2,
  7. G Ferrero2,
  8. G Garlaschi2
  1. 1Clinica Reumatologica, Dipartimento di Medicina Interna, Università di Genova, Genova, Italy
  2. 2Sezione di Diagnostica per Immagini, Dipartimento di Medicina Interna, Università di Genova, Genova, Italy
  1. Correspondence to Dr M A Cimmino, Clinica Reumatologica, Dipartimento di Medicina Interna e Specialità Mediche, Viale Benedetto XV, 16132 Genova, Italy; cimmino{at}unige.it

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Gouty arthritis (GA), a recurrent arthritis induced by precipitation of monosodium urate (MSU) crystals, has a 1.4% prevalence.1 2 The hands are affected in 24.7% of patients3 often with long-standing and diuretic-induced disease. Imaging can help in the differential diagnosis of GA and in understanding its pathogenic mechanisms. MRI has been mainly used to evaluate tophi4; information on synovitis, bone marrow oedema (BME) and erosions is scanty.

Eight patients affected by acute GA involving the wrist were considered. Gout was diagnosed using the American College of Rheumatology (ACR) criteria5 and confirmed by the identification of MSU crystals in tophi or synovial fluid. Immunoglobulin M rheumatoid factor (RF), anticyclic citrullinated protein (anti-CCP) antibodies, psoriasis or family history of psoriasis were absent. Gout patients were compared with eight patients with active (mean Disease Activity Score 28-CRP 5.78±0.95), RF and anti CCP antibodies positive, RA diagnosed according to the ACR criteria.6 All patients signed an informed consent. The study was approved by the local ethical committee.

MRI was performed during the …

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