Diagnostic Value of Ultrasound Imaging in Chronic Gouty Arthritis

LENG Qian-ying, TANG Yuan-jiao, ZHANG Ling-yan

Abstract

To determine the diagnostic value of ultrasound imaging in chronic gouty arthritis. Methods Ultrasound imaging of 32 patients with chronic gouty arthritis were compared with those of 36 patients with non-gouty joint diseases. A logistic model was obtained to establish the associations between ultrasound appereances and gouty arthritis. Receiver operator characteristic (ROC) curve was constructed to evaluate the performance of the logistic model. Results A double contour sign of articular cartilage, a snowstorm appearance of the joint fluid, and a hyperecho around the periarticular tendon had diagnostic value for chronic gouty arthritis. According to the logistic regression analysis, the accuracy of predicting chronic gouty arthritis was 95.59% (65/68), and the area under curve of ROC was 0.987±0.011 (P<0.05). Conclusion A double contour sign of articular cartilage, a snowstorm appearance of the joint fluid, and a hyperecho around the periarticular tendon have diagnostic value. The combination of these appearances can improve diagnosis of chronic gouty arthritis.

 

Keywords: Gout, Arthritis, Ultrasonic manifestations, Diagnosis 

 

Full Text:

PDF


References


Mogesen CE, Christensen CK. The diabetic kidney from hyperfiltration and micalbumin to endstage renal failure. Med Clin Nor Am. 1988;72(7); 1465-1469.

Machalkova K. Maisnar V. The role of procalcitonin in the differential diagnosis of fever in patiens with multiple myeloma. Klin Onkol, 2011;24(4);298-301.

Matwiyoff GN, Prahl JD, Miller RJ, et al. Immune regulation of procalcitonin; a biomarker and mediator of infection. Inflamm Res,2012; 61(5) ;401-409.

Gac AC, Parienti JJ, Chantepie S, et al. Dynamics of procalcitonin and bacteremia in neutropenic adults with acute myeloid leukemia. Leuk Res,2011; 35(10) ; 1294-1296.

Giovanella L, Suriano S, Ricci R. et al. Circulating procalcitonin in aseptic carcinoma patients; a specificity study with (18)F-fluorodeoxyglucose positron-emission tomography/ computed tomography as benchmark. Clin Chem Lab Med, 2010;48(8):1163-1165.

Standage SW, Wong HR. Biomarkers for pediatric sepsis and septic shock. Expert Rev Anti Infect Ther,2011 ;9( 1): 71-79.

Alter ML, Kretschmer A, Von Websky K. et al. Early urinary and plasma biomarkers for experimental diabetic nephropathy. Clin Lab, 2012;58(7-8);659-671.

Tashiro K, Koyanagi I, Ohara I, et al. Levels of urinary matrix metalloproteinase-9 ( MMP-9) and renal injuries in patients with type 2 diabetic nephropathy. J Clin Lab Anal, 2004; 18(3);206-210.

Oberhoffer M, Karzai W, Meier-Hellmann A, et al. Sensitivity and specificity of various markers of inflammation for the prediction of tumor necrosis factor-alpha and interleukin-6 in patients with sepsis. Crit Care Med, 1999; 27 (9):1814-1818.

Pedraza-Chaverri J, Cruz C, Tapia E, et al. Activity of serum enzymes in puromycin aminonucleoside-induced nephrotic syndrome. Ren Fail, 1992; 14(4) :523-531.

Smith HS, Bracken D. Smith JM. Gout: current insights and future perspectives. J Pain,2011; 12( 11) ; 1113-1129.

Chilappa CS, Aronow WS, Shapiro D, et al. Gout and hyperuricemia. Compr Ther, 2010; 36:3-13.

Tausche AK. Jansen TL, Schroder HE, et al. Gout current diagnosis and treatment. Dtsch Arztebl Int,2009; 106 (34-35);549-555.

Rettenbacher T, Ennemoser S, Weirich H, et al. Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-ray. Eur Radiol.2008; 18(3) :621-630.

Perez-Ruiz F, Dalbeth N, Urresola A, et al. Imaging of gout; findings and utility. Arthritis Res Ther. 2009 ; 11 (3): 232. doi: 10. 1186/ar2687. Epub 2009 Jun 17.

Thiele RG, Schlesinger N. Diagnosis of gout by ultrasound. Rheumatology (Oxford),2007;46(7); 1116-1121.

Dalbeth N, Clark B, Gregory K, et al. Computed tomography measurement of tophus volume; comparison with physical measurement. Arthritis Rheum,2007;57(3);461-465.

Kunkel G, Kaeley G, Thiele R. Comment on: an analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs. Rheumatology ( Oxford ), 2010; 49 (5):1022-1023.

Roddy E. Doherty M. Epidemiology of gout. Arthritis Res Ther,2010; 12(6) :223. doi; 10. 1186/ar3199. Epub 2010 Dec 21.

Thiele RG. Role of ultrasound and other advanced imaging in the diagnosis and management of gout. Curr Rheumatol Rep. 2011;13(2); 146-153.

Filippucci E, Scire СА, Delle Sedie A. et al. Ultrasound imaging for the rheumatologist. XXV. Sonographic assessment of the knee in patients with gout and calcium pyrophosphate deposition disease. Clin Exp Rheumatol, 2010; 28(1) :2-5.

Farina A, Filippucci E, Grassi W. Sonographic findings of the synovial fluid. Reumatismo.2002;54(3):261-265.

Pai V, Pai V, Muir R. Periarticular calcification causing acute carpal tunnel syndrome; a case report. J Orthop Surg ( Hong Kong),2009;17(2);234-237.

Coombs PR, Houseman N, White R, et al. Chronic tophaceous gout of the third flexor digitorum profundus tendon in the hand; an unusual sonography diagnosis. Am J Roentgenol.2006; 187(3) :313-315.

Siegal DS, Wu JS, Newman JS, et al. Calcific tendinitis; a pictorial review. Can Assoc Radiol J,2009 ;60(5);263-272.


Refbacks

  • There are currently no refbacks.