The presence of synovial monosodium urate monohydrate (MSU) crystals is the gold standard for diagnosing gout. But a new study, funded in part by the ACR and led by rheumatologists, including Alexis Ogdie, MD, MSCE, evaluated the effectiveness of ultrasound in diagnosing it. The study found that ultrasound can be useful in discriminating gout from non-gout.
“The idea was that if you are a primary care physician or you’re a rheumatologist but can’t do arthrocentesis, what’s the best way to diagnose gout?” says Dr. Ogdie, an assistant professor of medicine and epidemiology at the Hospital of the University of Pennsylvania. “A lot of rheumatologists now have ultrasound as part of their practice, and we wanted to know: What is the sensitivity and the specificity of ultrasound features for the diagnosis of gout?”
In the study, published in February in Arthritis & Rheumatology, the researchers wanted to reflect real-life clinical practice.1 Previous studies had relied on data from relatively small centers of gout expertise, among patients with a long history of the disease and showed that gout can be diagnosed by ultrasound upon detecting hyperechoic articular surface features on the hyaline cartilage (double contour sign, or DCS); a snowstorm appearance suggestive of floating, hyperechoic MSU crystals; or hyperechoic aggregates within the joint or along the tendons, which could indicate tophi.