Andrea Di Matteo1, Emilio Filippucci2, Edoardo Cipolletta2, Alice Musca3, Eleonora Di Donato2, Victoria Martire4, Diogo Jesus5, Fausto Salaffi2, Walter Grassi2. 1. Università Politecnica delle Marche, Clinica Reumatologica, Dipartimento di Scienze Cliniche e Molecolari, Ancona, 60126, Italy. Electronic address: andrea.dimatteo@hotmail.com. 2. Università Politecnica delle Marche, Clinica Reumatologica, Dipartimento di Scienze Cliniche e Molecolari, Ancona, 60126, Italy. 3. Internal Medicine and Rheumatology Department, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, 030167, Romania. 4. Instituto Médico Platense, La Plata, B1900AVG, Buenos Aires, Argentina. 5. Rheumatology Department, Centro Hospitalar e Universitario de Coimbra, Coimbra, 3075, Portugal.
Abstract
OBJECTIVES: To investigate the prevalence of the ultrasound findings indicative of monosodium urate crystal deposits at the hip joint in patients with gout and to explore the association between the ultrasound findings and the clinical and serological features. METHODS: Bilateral ultrasound assessment of the hip joint was carried out in 40 consecutive patients with gout, diagnosed according to the latest Gout American College of Rheumatology/European League Against Rheumatism classification criteria, and 25 disease controls. Ultrasound evidence of crystal deposits was obtained using the Outcome Measures in Rheumatology definitions: hip intra-articular aggregates and/or tophi, and "double contour" sign over the hyaline cartilage of the femoral head. RESULTS: The ultrasound examination revealed crystal deposits in at least one hip in 17 out of 40 patients (42.5%) with gout, and in 2 out of 25 disease controls (8.0%) (P = 0.0029). Aggregates, tophi, and "double contour" sign were found in at least one hip in 13 (32.5%), 6 (15.0%) and 6 (15.0%) out of 40 patients with gout, respectively. A moderate association between disease duration (P = 0.004, Rpb = 0.442), number of gouty "attacks" in the previous year (P = 0.029, Rpb = 0.346), presence of subcutaneous tophi (P = 0.037, V = 0.330) and ultrasound crystal deposits was found. CONCLUSION: Our results indicate that detecting monosodium urate crystals by ultrasound is common at hip joint in patients with gout.
OBJECTIVES: To investigate the prevalence of the ultrasound findings indicative of monosodium urate crystal deposits at the hip joint in patients with gout and to explore the association between the ultrasound findings and the clinical and serological features. METHODS: Bilateral ultrasound assessment of the hip joint was carried out in 40 consecutive patients with gout, diagnosed according to the latest Gout American College of Rheumatology/European League Against Rheumatism classification criteria, and 25 disease controls. Ultrasound evidence of crystal deposits was obtained using the Outcome Measures in Rheumatology definitions: hip intra-articular aggregates and/or tophi, and "double contour" sign over the hyaline cartilage of the femoral head. RESULTS: The ultrasound examination revealed crystal deposits in at least one hip in 17 out of 40 patients (42.5%) with gout, and in 2 out of 25 disease controls (8.0%) (P = 0.0029). Aggregates, tophi, and "double contour" sign were found in at least one hip in 13 (32.5%), 6 (15.0%) and 6 (15.0%) out of 40 patients with gout, respectively. A moderate association between disease duration (P = 0.004, Rpb = 0.442), number of gouty "attacks" in the previous year (P = 0.029, Rpb = 0.346), presence of subcutaneous tophi (P = 0.037, V = 0.330) and ultrasound crystal deposits was found. CONCLUSION: Our results indicate that detecting monosodium urate crystals by ultrasound is common at hip joint in patients with gout.