Original Article
Role of Ultrasonography in Diagnosing Gouty Arthritis

https://doi.org/10.1016/j.jmu.2011.01.003Get rights and content
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Urate crystal deposition in the joints is the hallmark of gout. The aim of our study is to determine the characteristic sonographic features of gouty arthritis, and to evaluate the utility of ultrasonography (US) in diagnosing gouty arthritis. Eighty patients with acute mono- or oligoarthritis who underwent US-guided joint aspiration for diagnostic purposes at our rheumatology division between March 2009 and March 2010 were enrolled. To compare the sonographic images of gouty and nongouty arthritis, US examinations were performed using a Philips EnVisor series ultrasound machine (Philips Medical Systems, USA) equipped with a 5–12 MHz linear transducer. Thirty-four patients had gouty arthritis (52 involved joints) and 46 patients had nongouty arthritis (52 involved joints). The most common joint sites were the knee and ankle in both groups. Hyperechoic deposition on the surface of the articular hyaline cartilage, namely, a double contour sign, suggested gout with a sensitivity of 36.8% and a specificity of 97.3%. Hyperechoic deposition in the synovium appearing as bright stippled foci, suggested gout with a sensitivity of 76.9% and a specificity of 65.4%. While considering both signs concurrently in diagnosing gouty arthritis, the specificity was 100%. The sonographic features of hyperechoic aggregations in synovial effusion, bone erosion, and synovial vascularity scores had no significant difference between gouty joints and nongouty joints. Double contour sign is specific to gout. The presence of both double contour sign and bright stippled foci indicates gouty arthritis among patients with acute mono- or oligoarthritis. US may play a relevant role in diagnosing gouty arthritis.

Key words

double contour sign
gouty arthritis
ultrasonic diagnosis

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Conflict of interest: None to declare.