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Abstract
Objective To summarise current data regarding the use of imaging in crystal-induced arthropathies (CiAs) informing a European Alliance of Associations for Rheumatology task force.
Methods We performed four systematic searches in Embase, Medline and Central on imaging for diagnosis, monitoring, prediction of disease severity/treatment response, guiding procedures and patient education in gout, calcium pyrophosphate dihydrate deposition (CPPD) and basic calcium phosphate deposition (BCPD). Records were screened, manuscripts reviewed and data of the included studies extracted. The risk of bias was assessed by validated instruments.
Results For gout, 88 studies were included. Diagnostic studies reported good to excellent sensitivity and specificity of dual-energy CT (DECT) and ultrasound (US), high specificity and lower sensitivity for conventional radiographs (CR) and CT. Longitudinal studies demonstrated sensitivity to change with regard to crystal deposition by US and DECT and inflammation by US and structural progression by CR and CT. For CPPD, 50 studies were included. Diagnostic studies on CR and US showed high specificity and variable sensitivity. There was a single study on monitoring, while nine assessed the prediction in CPPD. For BCPD, 56 studies were included. There were two diagnostic studies, while monitoring by CR and US was assessed in 43 studies, showing a reduction in crystal deposition. A total of 12 studies with inconsistent results assessed the prediction of treatment response. The search on patient education retrieved two studies, suggesting a potential role of DECT.
Conclusion This SLR confirmed a relevant and increasing role of imaging in the field of CiAs.
- Arthritis
- Gout
- Chondrocalcinosis
- Ultrasonography
Data availability statement
Data are available on reasonable request. Original data are available from authors on reasonable request.
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Data availability statement
Data are available on reasonable request. Original data are available from authors on reasonable request.
Footnotes
MAD’A and VN-C are joint senior authors.
IG and GS are joint first authors.
Handling editor Kimme L Hyrich
X @DrPeterMandl
Contributors IG: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. Drafting the work or revising it critically for important intellectual content. GS: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. Drafting the work or revising it critically for important intellectual content. BW: Substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. GF: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. Drafting the work or revising it critically for important intellectual content. PM: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. Drafting the work or revising it critically for important intellectual content. MAD’A: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. Drafting the work or revising it critically for important intellectual content. VN-C: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. Drafting the work or revising it critically for important intellectual content. All authors contributed and finally approved the current manuscript.IG and GS accepts full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish together with the senior authors (MD and VN-C) and the convenors of the taskforce (GF and PM). BW accepts responsibility for the search strategy.
Funding This study was reported by EULAR.
Competing interests VN-C: consulting fees: ABBvie, Galapagos, Lilly, Novartis, Lilly, Pfizer, UCB; honoraria: Abbvie, Fresenius, Lilly, Novartis, Pfizer, UCB; ASAS. MAD’A: consulting fees: Novartis, BMS, Janssen, Amgen, Boehringer Ingelheim, AbbVie, Astra-Zeneca, Pfizer, UCB, Eli Lilly; honoraria: Novartis, BMS, Janssen, Amgen, Boehringer Ingelheim, AbbVie, Astra-Zeneca, Pfizer, UCB, Eli Lilly. The other authors have no competing interests to declare.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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