Ultrasonography for diagnosing atypical gout. Two case reports.
Gout is characterized by the deposition of monosodium urate crystals on the surface of the articular cartilage, within periarticular tissues, and within bone and skin. The diagnosis rests on identification of the crystals in joint fluid or a tophus. However, joint aspiration is not always feasible, and the presentation may be atypical. We describe two cases of chronic gouty arthritis misdiagnosed as psoriatic arthritis. Ultrasonography of the bone and joints disclosed two patterns recently described as highly suggestive of gout, namely, the double-contour appearance of the cartilage and the snowstorm appearance of the synovial membrane. In addition, ultrasonography was useful for guided aspiration of joint fluid or other material containing monosodium urate crystals. Thus, ultrasonography may contribute to improve the diagnosis and treatment of gout.
Le Goff
Benoit
B
CHU de Nantes, Service de rhumatologie, 1 place Alexis Ricordeau, 44093 Nantes Cedex 1, France. benoit.legoff@chu-nantes.fr
Berthelot
Jean-Marie
JM
André
Vincent
V
Guillot
Pascale
P
Maugars
Yves
Y
D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis*; D002358:Cartilage, Articular / Q000000981:diagnostic imaging; D003078:Colchicine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006073:Gout / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000652:urine; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D007596:Joints / Q000473:pathology; D008297:Male; D013583:Synovial Membrane / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography; D014527:Uric Acid / Q000032:analysis
D006074:Gout Suppressants; D014527:Uric Acid; D003078:Colchicine