Objectives To determine sensitivity and specificity of ultrasound (US) findings for gout: “double contours” (DC) and hyperechogenic aggregates (HAGs) of symptomatic and asymptomatic joints in patients with gout.
Methods This prospective study included 69 persons (34 patients with primary gout and 35 healthy subjects). Including criteria for patients with gout were: age ≥18 years; diagnosis of primary gout; absence of acute gout attacks during the study tests; the absence of any other inflammatory and infectious joint disease, and secondary gout. The research included: demography and medical history. Physical and US examination covered following structures: 138 radiocarpal joint, 276 patellar and triceps tendon and 414 articular cartilages (first metatarsal, talar and femoral condyle).
Results Both groups were compatible for age and gender. In the gout group 124 (30%) symptomatic and 284 (70%) asymptomatic joints were found and in healty group all joints was asymptomatic. The sensitivity of the DC for symptomatic joint was 56 to 84% and specificity also was very high 91 to 94% as well as positive and negative predictive value (69 - 86% and 38 - 71%). Sensitivity of DC finding for the asymptomatic joints was 42 to 73% and specificity was 91 to 94%, with also high positive and negative predictive value (69 - 89% and 44 - 62%). The specificity of the HAGs for both symptomatic and asymptomatic joints was very high 99% but sensitivity of HAGs symptomatic structures was moderate (41 do 56%), while its sensitivity for asymptomatic structures was low (18 to 34%), table 1.
Conclusions Ultrasound examination of symptomatic and asymptomatic joints in patients with gout equally observed structural changes characteristic of gout. The finding of “double contours” in the symptomatic and asymptomatic joints has a very high sensitivity and specificity. Consequently, future research should be focused on the ultrasound examination of asymptomatic joints in patients with gout.
Disclosure of Interest None declared
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