OBJECTIVE: The main aim of the present study was to determine the sensitivity, specificity and accuracy of ultrasonography (US) in detecting monosodium urate and calcium pyrophosphate dihydrate crystals deposits at knee cartilage level using clinical definite diagnosis as standard reference. DESIGN: A total of 32 patients with a diagnosis of gout and 48 patients with pyrophosphate arthropathy were included in the study. Fifty-two patients with rheumatoid arthritis (RA), psoriatic arthritis or osteoarthritis (OA) were recruited as disease controls. All diagnoses were made using an international clinical criterion. US examinations were performed by an experienced sonographer, blind to clinical and laboratory data. Hyaline cartilage was assessed to detect two US findings recently indicated as indicative of crystal deposits: hyperechoic enhancement of the superficial margin of the hyaline cartilage and hyperechoic spots within the cartilage layer not generating a posterior acoustic shadow. RESULTS: Hyperechoic enhancement of the chondrosynovial margin was found in at least one knee of 14 out of 32 (43.7%) patients with gout and in a single knee of only one patient affected by pyrophosphate arthropathy (specificity=99%). Intra-cartilaginous hyperechoic spots were detected in at least one knee of 33 out of 48 (68.7%) patients with pyrophosphate arthropathy and in two disease controls one with OA and the second with RA (specificity=97.6%). CONCLUSIONS: The results of the present study indicate that US may play a relevant role in distinguishing cartilage involvement in patients with crystal-related arthropathy. The selected US findings were found to be highly specific.
OBJECTIVE: The main aim of the present study was to determine the sensitivity, specificity and accuracy of ultrasonography (US) in detecting monosodium urate and calcium pyrophosphate dihydrate crystals deposits at knee cartilage level using clinical definite diagnosis as standard reference. DESIGN: A total of 32 patients with a diagnosis of gout and 48 patients with pyrophosphate arthropathy were included in the study. Fifty-two patients with rheumatoid arthritis (RA), psoriatic arthritis or osteoarthritis (OA) were recruited as disease controls. All diagnoses were made using an international clinical criterion. US examinations were performed by an experienced sonographer, blind to clinical and laboratory data. Hyaline cartilage was assessed to detect two US findings recently indicated as indicative of crystal deposits: hyperechoic enhancement of the superficial margin of the hyaline cartilage and hyperechoic spots within the cartilage layer not generating a posterior acoustic shadow. RESULTS: Hyperechoic enhancement of the chondrosynovial margin was found in at least one knee of 14 out of 32 (43.7%) patients with gout and in a single knee of only one patient affected by pyrophosphate arthropathy (specificity=99%). Intra-cartilaginous hyperechoic spots were detected in at least one knee of 33 out of 48 (68.7%) patients with pyrophosphate arthropathy and in two disease controls one with OA and the second with RA (specificity=97.6%). CONCLUSIONS: The results of the present study indicate that US may play a relevant role in distinguishing cartilage involvement in patients with crystal-related arthropathy. The selected US findings were found to be highly specific.
Authors: Tomas Cazenave; Victoria Martire; Anthony M Reginato; Marwin Gutierrez; Christian Alfredo Waimann; Carlos Pineda; Javier Eduardo Rosa; Santiago Ruta; Oscar Sedano-Santiago; Ana Maria Bertoli; Marcelo Audisio; Cristina Hernandez-Diaz; Lucio Ventura-Rios; Maritza Quintero; Eugenio De Miguel; Ana Laura Alvarez-Del-Castillo-Araujo; Andy Abril; Eliana Natalí Ayala-Ledesma; Edith Alarcon-Isidro; Maria Lida Santiago; Mariana Alejandra Pera; Cecilia Urquiola; Gustavo Rodriguez Gil; Lina Maria Saldarriaga Rivera; Cesar Cefferino; Mariana Benegas; Mario Enrique Diaz Cortes; Maximiliano Bravo; Diana Peiteado; Natalia Anahi Estrella; Roser Areny Micas; Jorge Saavedra Muñoz; Rodolfo Del Carmen Arape Toyo; Maria Soledad Gálvez Elkin; Walter Javier Spindler; Clarisa Sandobal; Josefina Marin; Manuella Lima Gomes Ochtrop; Ricardo Pavao Ayala; Erika Roxana Catay; Guillermo Enrique Py; Gabriel Hector Aguilar; Yvonne Yona Rengel Colina; Carla Antonela Airoldi; Claudia Selene Mora-Trujillo; Maria Paula Kohan; Lorena Evelin Urioste Eguez; Concepción Castillo-Gallego; Jose Francisco Diaz-Coto; Patricio Tate; Carla Magali Saucedo; Oscar Vega-Hinojosa; Cristian Jonatan Troitiño; Maria Florencia Marengo; Priscila Maria Marcaida; Irene Monjo Henry; Roberto Muñoz-Louis; Carla Solano; Felix Reinaldo Fernandez Castillo; Cesar Enrique Graf; Mara Guinsburg; Maria Julia Santa Cruz; David Alejandro Navarta Ortiz; Magaly Alva Linares; Marcos Gabriel Rosemffet Journal: Rheumatol Int Date: 2018-12-11 Impact factor: 2.631
Authors: Nicola Dalbeth; Jaap Fransen; Tim L Jansen; Tuhina Neogi; H Ralph Schumacher; William J Taylor Journal: Rheumatology (Oxford) Date: 2013-04-22 Impact factor: 7.580