title: Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints.
abstract: The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as association with disease characteristics and laboratory findings. Twenty-seven male patients with established chronic gout agreed to participate, mean age 47.6 years, and mean disease duration in months 43.2 (±31.8). For all patients, detailed demographic, disease characteristics, and laboratory findings were obtained and correlated with MRI findings. In 27 patients with established gout, a total of 50 MRI studies were performed of the following joints: feet joints (n = 23), ankles (n = 18), knees (n = 5), and hand and wrist joints (n = 4). MRI revealed capsular thickening in 19 patients, bone marrow edema (BME) in 15, soft tissue edema (STE) in 20, joint effusion in 21, bone erosions in 17, cartilaginous erosions in 4, and tenosynovitis in 9 cases. In 17 cases, tophaceous lesions were found. Post contrast MRI showed synovial thickening in seven cases. Positive correlations were observed between serum uric acid levels and the following MRI findings: capsular thickening (r = 0.552, p = 0.003), BME (r = 0.668, p ≤ 0.0001), STE (r = 0.559, p = 0.002), and tenosynovitis (r = 0.513, p = 0.006). Using MRI in chronic gout, important features can be detected like BME, minute cartilaginous erosions, and hypertrophic synovial inflammation in post contrast MR images. Serum uric acid (SUA) was positively correlated with capsular thickening, BME, STE, and tenosynovitis.
authors: Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt. yasseremad68@gmail.com.|Rheumatology and Rehabilitation Department, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia. yasseremad68@gmail.com.
authors: Yasser
authors: Y
authors: Emad
authors: Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.|Radiology Department, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia.
authors: Yasser
authors: Y
authors: Ragab
authors: Orthopedic Department, Faculty of Medicine, Cairo University, Cairo, Egypt.|Orthopedic Department, Dr. Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia.
authors: Ahmed
authors: A
authors: El-Naggar
authors: Rheumatology and Rehabilitation Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors: Nashwa
authors: N
authors: El-Shaarawy
authors: Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors: Mayada A
authors: MA
authors: Abd-Allah
authors: Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Asyut, Egypt.
authors: Rania M
authors: RM
authors: Gamal
authors: Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors: Ahmed
authors: A
authors: Fathy
authors: Internal Medicine Department, Nephrology Unit, Agouza Police Hospital, Cairo, Egypt.
authors: Mona
authors: M
authors: Hawass
authors: Rheumatology Department, University of Twente, Enschede, The Netherlands.
authors: Johannes J
authors: JJ
authors: Rasker
mesh_terms: D000328:Adult; D000842:Ankle / Q000473:pathology; D015210:Arthritis, Gouty / Q000097:blood* / Q000473:pathology*; D005528:Foot / Q000473:pathology; D005682:Gadolinium; D006801:Humans; D007717:Knee / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014527:Uric Acid / Q000097:blood*; D014955:Wrist Joint / Q000473:pathology
chemical_list: D014527:Uric Acid; D005682:Gadolinium
keywords: Bone marrow edema in gouty arthritis; Gout; Gouty arthritis; MRI in gouty arthritis; Tophaceous gout