An Ultrasonographic Study for Investigating Relationships with the Signs of Uric Deposition and Bone Erosion in Patients with Hyperuricemia

Ikuko Tanaka¹, Takashi Kato², Motokazu Kai³, Kunikazu Ogawa³, Hisaji Oshima⁴ and Shigenori Tamaki⁵, ¹NAGOYA Rheumatology Clinic, Nagoya, Japan, ²Department of Radiology, National Center for Geratrics and Gerontology, Obu, Japan, ³Mie Rheumatology Clinic, Suzuka, Japan, ⁴Department of Connective Tissue Diseases, National Tokyo Medical Center, Tokyo, Japan, ⁵Nagoya Rheumatology Clinic, Nagoya, Japan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Arthritis, gout, joint destruction, ultrasonography and uric acid

Session Information

Date: Sunday, November 5, 2017

Title: Imaging of Rheumatic Diseases Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Joint ultrasonography (US) is a noninvasive examination that can evaluate arthritis and uric acid deposition at gout attacks.

The purpose of this study was to investigate the progression of gouty arthritis using cross sectional data from the aspect of the joint sonographic features such as double contour sign (DCS), hyperechoic aggregate (HA), and bone erosion (BE). DCS and HA are signs showing uric acid deposition.

Methods:

The subjects were 644 consecutive male patients (Age: 45.7±10.7 y.o.) with hyperuricemia and/or gout attack. Seventy one patients (11%) had experienced neither any attacks nor diagnosis of gout (N group). One hundred eighty seven patients (29%) were diagnosed as the first attack of gout (1st group), while 386 patients (60%) had their past history of the attacks (His group). They underwent joint US. Observed rates of DCS, HA, and BE (D: only DCS; H: only HA; B: both DCS and HA; A: DCS or HA; E: BE) in the first metatarsophalangeal (1st MTP) were compared.

Results:

In the N group, the observed rates of D, H, B, A, and E were 45%, 1%, 0%, 46%, and 1%, respectively. In the 1st group, arthritis on US was observed in the joints of the first metatarsophalangeal (1st MTP) (72%), ankle (18%), and knee (5%). In the 1st group, the patients of which attack was at 1st MTP represented that observe rates were D 29%, H 20%, B 38%, A 87%, and E 29%, while the patients of which attack was at other than 1st MTP were D 20%, H 4%, B 0%, A 24%, and E 0%. In His group, the observed rates were D 16%, H 18%, B 66%, A 100%, and E 57%. Observed frequency of DCS was highest in N group and was decreased along with articular destruction, respectively. In His group, 100% and more than 50% patients showed sonographic features of ureic acid deposition and bone erosion. Fisher’s exact tests demonstrated a significant relationship in HA and BE, but not in DCS and BE (p<0.05).

Conclusion:

The results suggested that DCS was the earliest sign of uric acid deposition that was observed in the asymptomatic stage in gount. Even at the first attack HA was frequently observed that was leading to BE.

Disclosure: I. Tanaka, None; T. Kato, None; M. Kai, None; K. Ogawa, None; H. Oshima, None; S. Tamaki, None.

To cite this abstract in AMA style:

Tanaka I, Kato T, Kai M, Ogawa K, Oshima H, Tamaki S. An Ultrasonographic Study for Investigating Relationships with the Signs of Uric Deposition and Bone Erosion in Patients with Hyperuricemia [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/an-ultrasonographic-study-for-investigating-relationships-with-the-signs-of-uric-deposition-and-bone-erosion-in-patients-with-hyperuricemia/. Accessed .

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