Relevant aspects of imaging in the diagnosis and management of gout

Relevant aspects of imaging in the diagnosis and management of gout

Title: Relevant aspects of imaging in the diagnosis and management of gout;
Aspectos relevantes do diagnóstico e seguimento por imagem na gota
Author Fernandes, Eloy de Avila Autor UNIFESP Google Scholar
Bergamaschi, Samuel Brighenti Google Scholar
Rodrigues, Tatiane Cantarelli Google Scholar
Dias, Gustavo Coelho Google Scholar
Malmann, Ralff Google Scholar
Ramos, Germano Martins Google Scholar
Monteiro, Soraya Silveira Autor UNIFESP Google Scholar
Abstract Gout is an inflammatory arthritis characterized by the deposition of monosodium urate crystals in the synovial membrane, articular cartilage and periarticular tissues leading to inflammation. Men are more commonly affected, mainly after the 5th decade of life. Its incidence has been growing with the population aging. In the majority of the cases, the diagnosis is made by clinical criteria and synovial fluid analysis, in search for monosodium urate crystals. Nonetheless, gout may sometimes have atypical presentations, complicating the diagnosis. In these situations, imaging methods have a fundamental role, aiding in the diagnostic confirmation or excluding other possible differential diagnosis. Conventional radiographs are still the most commonly used method in gout patients' evaluation

nevertheless, this is not a sensitive method, since it detect only late alterations. In the last years, there have been several advances in imaging methods for gout patients. Ultrasound has shown a great accuracy in the diagnosis of gout, identifying monosodium urate deposits in the synovial membrane and articular cartilage, in detecting and characterizing tophi and in identifying tophaceous tendinopathy and enthesopathy. Ultrasound has also been able to show crystal deposition in patients with articular pain in the absence of a classical gout crisis. Computed tomography is an excellent method for detecting bone erosions, being useful in spine involvement. Dual-energy CT is a new method able to provide information about the chemical composition of tissues, with high accuracy in the identification of monosodium urate deposits, even in the early stages of the disease and in cases of difficult characterization. Magnetic resonance imaging is useful in the evaluation of deep tissues not accessible by ultrasound. Besides the diagnosis, with the emergence of new drugs that aim to reduce tophaceous burden, imaging methods have become useful tools in monitoring the treatment of patients with gout. (C) 2016 Published by Elsevier Editora Ltda.
Keywords Gout
Magnetic resonance imaging
Dual-energy computed tomography
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2017
Published in Revista Brasileira De Reumatologia. New York, v. 57, n. 1, p. 64-72, 2017.
ISSN 0482-5004 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 64-72
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000396445600009

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