| Imaging of tophaceous gout: computed tomography provides specific images compared with magnetic resonance imaging and ultrasonography. | |
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MedLine Citation:
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PMID: 11779759 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the usefulness of computed tomography (CT), magnetic resonance imaging (MRI), and Doppler ultrasonography (US) in providing specific images of gouty tophi. METHODS: Four male patients with chronic gout with tophi affecting the knee joints (three cases) or the olecranon processes of the elbows (one case) were assessed. Crystallographic analyses of the synovial fluid or tissue aspirates of the areas of interest were made with polarising light microscopy, alizarin red staining, and x ray diffraction. CT was performed with a GE scanner, MR imaging was obtained with a 1.5 T Magneton (Siemens), and ultrasonography with colour Doppler was carried out by standard technique. RESULTS: Crystallographic analyses showed monosodium urate (MSU) crystals in the specimens of the four patients; hydroxyapatite and calcium pyrophosphate dihydrate (CPPD) crystals were not found. A diffuse soft tissue thickening was seen on plain radiographs but no calcifications or ossifications of the tophi. CT disclosed lesions containing round and oval opacities, with a mean density of about 160 Hounsfield units (HU). With MRI, lesions were of low to intermediate signal intensity on T(1) and T(2) weighting. After contrast injection in two cases, enhancement of the tophus was seen in one. Colour Doppler US showed the tophi to be hypoechogenic with peripheral increase of the blood flow in three cases. CONCLUSION: The MR and colour Doppler US images showed the tophi as masses surrounded by a hypervascular area, which cannot be considered as specific for gout. But on CT images, masses of about 160 HU density were clearly seen, which correspond to MSU crystal deposits. |
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Authors:
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J C Gerster; M Landry; L Dufresne; J Y Meuwly |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Annals of the rheumatic diseases Volume: 61 ISSN: 0003-4967 ISO Abbreviation: Ann. Rheum. Dis. Publication Date: 2002 Jan |
Date Detail:
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Created Date: 2002-01-07 Completed Date: 2002-01-17 Revised Date: 2008-11-20 |
Medline Journal Info:
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Nlm Unique ID: 0372355 Medline TA: Ann Rheum Dis Country: England |
Other Details:
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Languages: eng Pagination: 52-4 Citation Subset: IM |
Affiliation:
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Department of Rheumatology, University Hospital (CHUV), Lausanne, Switzerland. Jean.Charles.Gerster@chuv.hospvd.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Contrast Media Crystallography Gout / diagnosis* Humans Magnetic Resonance Imaging / standards Male Microscopy, Polarization Middle Aged Sensitivity and Specificity Tomography, X-Ray Computed / standards Ultrasonography, Doppler, Color / standards |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
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