Imaging modalities for the classification of gout: systematic literature review and meta-analysis.

Abstract:

BACKGROUND:Although there has been major progress in gout imaging, no gout classification criteria currently include advanced imaging techniques. OBJECTIVE:To examine the usefulness of imaging modalities in the classification of gout when compared to monosodium urate (MSU) crystal confirmation as the gold standard, in order to inform development of new gout classification criteria. METHODS:We systematically reviewed the published literature concerning the diagnostic performance of plain film radiography, MRI, ultrasound (US), conventional CT and dual energy CT (DECT). Only studies with MSU crystal confirmation as the gold standard were included. When more than one study examined the same imaging feature, the data were pooled and summary test characteristics were calculated. RESULTS:11 studies (9 manuscripts and 2 meeting abstracts) satisfied the inclusion criteria. All were set in secondary care, with mean gout disease duration of at least 7 years. Three features were examined in more than one study: the double contour sign (DCS) on US, tophus on US, and MSU crystal deposition on DECT. The pooled (95% CI) sensitivity and specificity of US DCS were 0.83 (0.72 to 0.91) and 0.76 (0.68 to 0.83), respectively; of US tophus, were 0.65 (0.34 to 0.87) and 0.80 (0.38 to 0.96), respectively; and of DECT, were 0.87 (0.79 to 0.93) and 0.84 (0.75 to 0.90), respectively. CONCLUSIONS:US and DECT show promise for gout classification but the few studies to date have mostly been in patients with longstanding, established disease. The contribution of imaging over clinical features for gout classification criteria requires further examination.

journal_name

Ann Rheum Dis

authors

Ogdie A,Taylor WJ,Weatherall M,Fransen J,Jansen TL,Neogi T,Schumacher HR,Dalbeth N

doi

10.1136/annrheumdis-2014-205431

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

1868-74

issue

10

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2014-205431

journal_volume

74

pub_type

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