Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Recent studies have suggested that synovial fluid uric acid could contribute to tissue inflammation, disease severity and progression of osteoarthritis (OA). Intraarticular uric acid has been associated with OA disease severity and may promote cartilage destruction through inflammasome activation.We aimed to explore if intraarticular uric acid deposition does indeed occur in patients with osteoarthritis of the knee who have never experienced an episode of gout .
Methods:
We recruited patients with advanced osteoarthritis of the knee and no history of gout who were scheduled to undergo knee replacement surgery. All subjects underwent dual-energy scanning of the target joint. CT images were screened for areas of uric acid deposition.During knee replacement surgery, samples of tibial and femoral condyle cartilage, menisci and synovium were obtained. Areas of possible uric acid deposition as identified through DECT were particularly targeted for sample collection.A musculoskeletal pathologist performed light (DeGalantha and H&E stains) and polarizing microscopy and recorded the presence of uric acid crystals in a descriptive manner.
Results:
5 patients with advanced osteoarthritis of the knee did undergo DECT. In all subjects, DECT indicated areas of uric acid deposition within the joint cartilage and the menisci. In 4 of these 5 patients, histopathology exam confirmed presence of uric acid crystal clusters in the cartilage and/or menisci. In 2 patients, uric acid deposition did also involve the synovium. Of note, synovial fluid in all patients was negative for MSU crystals as determined through polarizing microscopy. The mean serum uric acid level was 5.7mg/dl, range 5.0-6.4 mg/dl.
Conclusion:
This pilot study did reveal evidence of cartilaginous uric acid deposition in the majority of patients with advanced osteoarthritis.Future studies will have to confirm this finding in a larger patient cohort and clarify if intracartilaginous urate crystals accelerate cartilage damage or are simply a result of matrix exposure and subsequent MSU crystallization without significant effects on disease progression.
Disclosure:
T. Bongartz,
None;
A. M. Oliveira,
None;
R. J. Sierra,
None;
A. D. Hanssen,
None;
M. J. Taunton,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cartilaginous-uric-acid-deposition-in-advanced-osteoarthritis-innocent-bystander-or-promotor-of-cartilage-destruction/