Role of diagnostic ultrasonography in detecting gouty arthritis

IntroductionGout is a form of inflammatory arthritis that is characterized by attacks of active synovitis related to the presence of monosodium urate (MSU) crystals in the joints and periarticular soft tissues.Aim of the workTo establish the usefulness of ultrasonography (US) in diagnosing subclinical gouty arthritis and to determine whether there are sonographic features that are characteristic of gout.Patients and methodsWe studied 20 patients known to be gouty (group 1), 20 patients with asymptomatic hyperuricemia (AH) (group 2) and 20 controls (group 3) in a cross sectional study. Demographic, clinical and serological data were evaluated. Knee and 1st MTP joints were assessed by musculoskeletal (US) to detect subclinical gouty arthritis.ResultsClinical gouty arthritis was found in only (20%) in (group 1), but subclinical gouty arthritis had been found in (75%) in (group1) and (25%) in (group 2). There were statistically significant differences between the examined groups regarding the presence of double contour (DC) sign (p < 0.001), joint effusion (p = 0.04), serum uric acid (SUA) level (p < 0.001), diuretics use (p < 0.001), allopurinol use (p < 0.001), also it was found that only SUA was the risk factor for the occurrence of the double contour (DC) sign (p = 0.03) and cut-off value of SUA was 9.1 mg/dl above which DC sign was detected.ConclusionUltrasonography (US) is a useful tool to detect subclinical gouty arthritis; also serves as a non-invasive, bedside and non-ionizing tool.