Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia
Objective. To evaluate monosodium urate (MSU) crystal deposition and related lesions in the joints of patients with gout and hyperuricemia (HUA) using ultrasound. To explore the association between ultrasound findings and clinical features in gout and HUA. Methods. A total of 202 patients with gout...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2021/5550626 |
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| author | Ling Cao Tianyi Zhao Chunmei Xie Shucong Zheng Weiguo Wan Hejian Zou Xiaoxia Zhu |
| author_facet | Ling Cao Tianyi Zhao Chunmei Xie Shucong Zheng Weiguo Wan Hejian Zou Xiaoxia Zhu |
| author_sort | Ling Cao |
| collection | DOAJ |
| description | Objective. To evaluate monosodium urate (MSU) crystal deposition and related lesions in the joints of patients with gout and hyperuricemia (HUA) using ultrasound. To explore the association between ultrasound findings and clinical features in gout and HUA. Methods. A total of 202 patients with gout and 43 asymptomatic patients with HUA were included. The clinical data and ultrasonic assessment results were collected and statistically analyzed. Results. Deposition of MSU crystals was found in 25.58% (11/43) of patients with asymptomatic HUA and 76.24% (154/202) of patients with gout. Of the 1,082 joints from patients with gout examined, 33.09% (358/1082) displayed MSU crystal deposition. In the joints with MSU crystal deposition, 77.37% (277/358) had a history of attacks. Among the joints of gouty arthritis, double contour sign (DCS), hyperechoic aggregate (HAG), and tophi were found in 32.65% (159/487), 7.80% (38/487), and 24.64% (120/487) of the joints, respectively. DCS and tophi, but not HAG, increasingly appeared with the extension of gout duration. In patients with more than 15 years of gout history, DCS, Tophi, and HAG were found in 48.18%, 40.00%, and 6.36% of US assessed joints, respectively. In patients with gout, synovial lesion and bone erosion were found in 17.74% (192/1082) and 7.58% (82/1082) of joints, respectively. The synovial lesion was related to HAG, while bone erosion was related to tophi and DCS. Nephrolithiasis was detected in 20.30% (41/202) of patients with gout and 4.65% (2/43) of HUA patients, indicating that nephrolithiasis occurred in more patients with gout than in patients with HUA. Conclusion. HAG is an early performance of MSU crystal deposition in joints of gout and HUA. Both DCS and tophi are risk factors for bone erosion. Early urate-lowering therapy (ULT) should be considered in patients with gout, DCS, or tophi. |
| format | Article |
| id | doaj-art-e4f6803b8051461f86d46ba3029dbc43 |
| institution | Kabale University |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-e4f6803b8051461f86d46ba3029dbc432025-02-03T06:46:14ZengWileyJournal of Immunology Research2314-88612314-71562021-01-01202110.1155/2021/55506265550626Performance of Ultrasound in the Clinical Evaluation of Gout and HyperuricemiaLing Cao0Tianyi Zhao1Chunmei Xie2Shucong Zheng3Weiguo Wan4Hejian Zou5Xiaoxia Zhu6Division of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, ChinaDivision of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, ChinaInstitute of Rheumatology, Immunology, and Allergy, Fudan University, Shanghai, 200040, ChinaDivision of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, ChinaDivision of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, ChinaDivision of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, ChinaDivision of Rheumatology, Huashan Hospital, Fudan University, Shanghai, 200040, ChinaObjective. To evaluate monosodium urate (MSU) crystal deposition and related lesions in the joints of patients with gout and hyperuricemia (HUA) using ultrasound. To explore the association between ultrasound findings and clinical features in gout and HUA. Methods. A total of 202 patients with gout and 43 asymptomatic patients with HUA were included. The clinical data and ultrasonic assessment results were collected and statistically analyzed. Results. Deposition of MSU crystals was found in 25.58% (11/43) of patients with asymptomatic HUA and 76.24% (154/202) of patients with gout. Of the 1,082 joints from patients with gout examined, 33.09% (358/1082) displayed MSU crystal deposition. In the joints with MSU crystal deposition, 77.37% (277/358) had a history of attacks. Among the joints of gouty arthritis, double contour sign (DCS), hyperechoic aggregate (HAG), and tophi were found in 32.65% (159/487), 7.80% (38/487), and 24.64% (120/487) of the joints, respectively. DCS and tophi, but not HAG, increasingly appeared with the extension of gout duration. In patients with more than 15 years of gout history, DCS, Tophi, and HAG were found in 48.18%, 40.00%, and 6.36% of US assessed joints, respectively. In patients with gout, synovial lesion and bone erosion were found in 17.74% (192/1082) and 7.58% (82/1082) of joints, respectively. The synovial lesion was related to HAG, while bone erosion was related to tophi and DCS. Nephrolithiasis was detected in 20.30% (41/202) of patients with gout and 4.65% (2/43) of HUA patients, indicating that nephrolithiasis occurred in more patients with gout than in patients with HUA. Conclusion. HAG is an early performance of MSU crystal deposition in joints of gout and HUA. Both DCS and tophi are risk factors for bone erosion. Early urate-lowering therapy (ULT) should be considered in patients with gout, DCS, or tophi.http://dx.doi.org/10.1155/2021/5550626 |
| spellingShingle | Ling Cao Tianyi Zhao Chunmei Xie Shucong Zheng Weiguo Wan Hejian Zou Xiaoxia Zhu Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia Journal of Immunology Research |
| title | Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia |
| title_full | Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia |
| title_fullStr | Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia |
| title_full_unstemmed | Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia |
| title_short | Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia |
| title_sort | performance of ultrasound in the clinical evaluation of gout and hyperuricemia |
| url | http://dx.doi.org/10.1155/2021/5550626 |
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