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Diagnosis of gout in patients with asymptomatic hyperuricaemia: a pilot ultrasound study
  1. Eugenio De Miguel1,
  2. Juan G Puig2,
  3. Concepción Castillo1,
  4. Diana Peiteado1,
  5. Rosa J Torres3,
  6. Emilio Martín-Mola1
  1. 1Division of Rheumatology, La Paz University Hospital, Madrid, Spain
  2. 2Division of Internal Medicine, La Paz University Hospital, Madrid, Spain
  3. 3Division of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
  1. Correspondence to Eugenio De Miguel, La Paz University Hospital, Rheumatology Unit, Pª de la Castellana 261, 28046 Madrid, Spain; eugenio.demiguel{at}

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Asymptomatic hyperuricaemia is defined as a serum urate concentration equal to or above 7.0 mg/dl with no symptoms or clinical signs. Most individuals with hyperuricaemia, however, do not develop gouty arthritis. The annual incidence of gout is 0.5% in subjects with uric acid levels from 7.0 to 8.9 mg/dl, rising to 4.9% in those with uric acid levels higher than 9.0 mg/dl.1 However, only 12% of patients with serum uric acid levels between 7 and 7.9 mg/dl who were followed for 14 years developed gout.2 There are no accurate predictors of gout in this population and, as a consequence, we ignore the patients who may benefit from an early urate-lowering therapy intervention. The aim of this pilot study was to investigate the prevalence of gout in patients with asymptomatic hyperuricaemia and to investigate the accuracy of ultrasound in the diagnosis of gout in this population. …

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  • Funding This study was supported by grants from the National Health Service: Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (FIS, 08/0009), the Red Española de Atención Primaria (2009/70) and RECAVA (RD06/0014/0019).

  • Competing interest None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted according to local regulations and the declaration of Helsinki, and local approval was obtained from the ethical committee and the Institutional Review Board of the Hospital Universitario La Paz, Madrid, Spain.

  • Provenance and peer review Not commissioned; externally peer reviewed.