Musculoskeletal ultrasonography in patients with gout: A single-institute experience at the Institute of Rheumatology, Tokyo Women's Medical University.

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  • 痛風患者における関節超音波検査の実際　東京女子医科大学附属膠原病リウマチ痛風センターにおける経験

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The utility of musculoskeletal ultrasonography (US) has recently been focused on, and it has been described as being able to evaluate monosodium urate (MSU) crystal deposition in joints, such as microtophi and the double contour sign, with the latter specifically representing MSU crystal deposition on the surface of articular cartilage. We present our US experience involving patients with gout during the 18 months from July 2009, including two patients in whom a reduction of MSU crystal deposition was observed by US due to treatment for hyperuricemia. We performed US assessments in 47 patients (46 males, average age : 54.8 years) with gout who had attended for more than a year. Retrospective analysis of these examinations revealed that there were cases with residual crystal deposition regardless of the disease duration, duration of urate-lowering treatments, or the current serum urate concentration, which suggests that an excessive urate pool remains in the body if treatment for hyperuricemia, even for a long period of time, is insufficient. It is possible to closely control patients with gout to achieve optimized treatment goals through noninvasively evaluating residual MSU crystal deposition by US.

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