title: Temporal evolution of urate crystal deposition over articular cartilage after successful urate-lowering therapy in patients with gout: An ultrasonographic perspective.
abstract: OBJECTIVE
  To detect evolution of ultrasonographic signs of deposition of monosodium urate crystals (MSUC) in gouty joints by serial ultrasonography after initiation of urate-lowering therapy (ULT).
  
  
  METHODS
  Adult gout patients were examined by serial ultrasonography after initiation of ULT with target serum uric acid (SUA) < 6 mg/dL.
  
  
  RESULTS
  Thirty-eight male patients with gout with mean age of 50 ± 11 years, median disease duration of 48 months and baseline mean SUA level of 8.8 ± 1.5 mg/dL were recruited. Ultrasonographic evidence of MSUC deposition was detected in 89.74% of first metatarsophalangeal (MTP) joints and 27.63% of knee joints. Double contour sign (DCS), tophi, and hyperechoic spots (HES) were detected in 77.63%, 43.42%, and 19.74% of first MTPs, respectively. SUA level normalizes and plateaus after fourth month of follow-up. DCS thickness reduced significantly throughout the follow-up period. Overall, 86.25% DCS and 100% HES disappeared with median time of 6 months and 5.7 months, respectively. SUA normalization was the only significant predictor of DCS disappearance.
  
  
  CONCLUSIONS
  Serial ultrasonographic determination of DCS, tophi, or HES during hypouricemic therapy is a noninvasive, effective method to detect the lowering of burden of urate load in gouty joints.
authors: a Department of Rheumatology , Institute of Postgraduate Medical Education and Research , Kolkata , West Bengal , India.
authors: Shyamashis
authors: S
authors: Das
authors: a Department of Rheumatology , Institute of Postgraduate Medical Education and Research , Kolkata , West Bengal , India.
authors: Rudra Prosad
authors: RP
authors: Goswami
authors: a Department of Rheumatology , Institute of Postgraduate Medical Education and Research , Kolkata , West Bengal , India.
authors: Alakendu
authors: A
authors: Ghosh
authors: a Department of Rheumatology , Institute of Postgraduate Medical Education and Research , Kolkata , West Bengal , India.
authors: Parasar
authors: P
authors: Ghosh
authors: a Department of Rheumatology , Institute of Postgraduate Medical Education and Research , Kolkata , West Bengal , India.
authors: Debasish
authors: D
authors: Lahiri
authors: a Department of Rheumatology , Institute of Postgraduate Medical Education and Research , Kolkata , West Bengal , India.
authors: Kaushik
authors: K
authors: Basu
mesh_terms: D000328:Adult; D000368:Aged; D002358:Cartilage, Articular / Q000000981:diagnostic imaging* / Q000378:metabolism; D006073:Gout / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging* / Q000378:metabolism; D008875:Middle Aged; D014527:Uric Acid / Q000097:blood
chemical_list: D006074:Gout Suppressants; D014527:Uric Acid
keywords: Double contour sign; Gout; Serial ultrasonography; Ultrasonography; Urate crystal