Table 4

Summary of studies detailing articular cartilage involvement in gout

AuthorPathologyResultsInter-reader reliabilityFeasibility
Thiele and Schlesinger18Hyperechoic band over anechoic cartilage (DC)Present in 92% gout, 0% controls (p<0.001)UCNo
Wright et al19A focal or diffuse enhancement of the superficial margin of the articular cartilage whose reflectivity is independent of the angle of insonation (DC)In gout—22% MTP joints and in controls—0%, (p=0.01)NRNo
Filippucci et al24Hyperechoic enhancement of the superficial margin of the hyaline cartilage (DC)Present in 43.7% of gout subjects, 2% of CPPD subjects, 0% other rheumatic diseases
Sensitivity=43.7%; specificity=99%; and accuracy=85.6%
Inter occasion
PEA 92.7%. ICC=0.56. κ=0.68
Thiele and Schlesinger25Hyperechoic, irregular coating of the hyaline cartilage in the examined joints (DC)Disappearance of the DC sign was seen with normalisation of uric acid levels with ULTNRNR
Filippucci et al27DCIn gout—41.6%, in CPPD—0.7%NRNR
Hyperechoic spots within the cartilage layerIn gout—0% and in CPPD—64.2%NRNR
Meniscal calcificationIn gout—0% and in CPPD—77%NRNR
Howard et al29Hyperechoic band over cartilage (DC)In gout—30% and in unaffected joint—11% (p=0.315)Intraoccasion rereading
Ottaviani et al30Hyperechoic, irregular
band over the superficial margin of the
articular cartilage(DC)
In early gout—60%.
Present in every joint with tophi.
Intraoccasion rereading κ=0.92–0.98NR
Filippucci et al31Enhancement of the
superficial margin of the hyaline cartilage
10% of joints (42 in dorsal and 4 in volar aspect of MTP)NRNR
Pineda et al32Hyperechoic enhancement of the superficial
margin of hyaline cartilage(DC)
Present in first MTP joint —25% in AH and 0% in controls (p<0.0001) and in knee joint—17% AH and 0% controls (p<0.0001)NoNo
De Miguel et al33DCSeen in 7/26 patients with asymptomatic hyperuricaemiaUCNo
  • CPPD, calcium pyrophosphate dihydrate; DC, double contour; ICC, intraclass correlation coefficient; MTP, metatarsophalangeal; NR, not reported; PEA, percentage exact agreement; UC, unclear; ULT, urate lowering therapy.