Background Asymptomatic hyperuricaemia is the most important risk factor in the development of gout, as the risk of acute arthritis rises exponentially with the serum levels of uric acid. It is a common condition, estimated at 15-20% in the general population and even though asymptomatic, approximately 20% of patients with untreated high uric acid levels develop gout over the following 5 years.
Unfortunately there is not enough data available about subclinical urate crystal deposition and the joint damage that it causes.
Objectives This study aimed to demonstrate that high levels of serum uric acid can induce changes suggestive of gout in the hyaline cartilage, joints and tendons of patients with asymptomatic hyperuricaemia.
Method The study was a cross-sectional study on 30 patients with hyperuricaemia with no history of gout. An ultrasound examination on the knees and first methatarsophalangeal joints was performed.
Results Synovitis was found in 7 patients (23%), 6 patients had erosions (20%), 9 patients had tophaceous material (30%) and 2 patients had DCS (6.6%). There was a slightly higher rate of findings in men than in women (8 men vs 5 women).
Conclusion The study confirms that sustained high levels of serum uric acid can induce subclinical articular and periarticular urate deposits, synovitis and joint erosions that are detectable on ultrasound. These ultrasound findings may allow early diagnosis and treatment of gout in patients with hyperuricaemia.
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Disclosure of Interest None declared
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