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An exploratory ultrasound study of early gout.
MedLine Citation:
PMID:  22011529     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: We aimed to determine by ultrasonography (US) the prevalence of articular monosodium urate deposits in patients with gout who do not require urate lowering therapy (ULT) according to international recommendations. METHODS: In this prospective study, we enrolled patients with proven gout demonstrated by crystals in synovial fluid but who did not require ULT. Two trained ultrasonographers assessed 10 joints per patient (metatarsophalangeal [MTP] joints 1-2, knees, metacarpophalangeal [MCP] joints 2-3) to determine the prevalence of the double-contour (DC) sign and tophi in each site. RESULTS: We studied 150 joints from 15 patients (median age 56.9 years [interquartile range 31.7] years; 14 males). The median number of acute attacks per patient was 2.0 [0.7]. Interobserver agreement was good to excellent for all articular sites. The prevalence of the DC sign in the knees and MTP joints was 46.7% and 40% respectively, whereas that of tophi was 26.7% for both sites. No urate deposits were found in MCP joints. The DC sign and tophi were found in at least one articular site in 60% and 46.7% of patients, respectively. All patients with urate levels > 600 μM (10 mg/dl) had a DC sign in at least 1 assessed joint. Urate levels were positively correlated with presence of the DC sign in knees (p=0.005) and MTP joints (p=0.03) but not presence of tophi. CONCLUSIONS: In this study, ultrasonography allowed for detecting articular urate deposits in 60% of gouty patients not requiring ULT by international recommendations.
Authors:
Sébastien Ottaviani; Anne Allard; Thomas Bardin; Pascal Richette
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-19
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  -     ISSN:  0392-856X     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Université Paris 7, UFR médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, 75475 Paris Cedex 10, France. sebastien.ottaviani@bch.aphp.fr.
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