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Gout of hand and wrist: the value of US as compared with DECT.

Abstract：

OBJECTIVES:The purpose of this study was to compare findings of ultrasound (US) with dual-energy CT (DECT) in patients presenting with suspected gouty hand and wrist arthritis. METHODS:This prospective study included 180 patients (136 men and 44 women, age range, 31- 94 years; mean age, 65.9 years) with an initial clinical diagnosis of acute gouty arthritis who underwent DECT and US examination. Intra- and extra-articular findings of each modality were tabulated and calculated with DECT as gold standard. RESULTS:The final diagnosis of gout was positive in 97/180 patients (53.9%) by DECT, an alternative diagnosis confirmed in 83 patients. US showed a sensitivity of 70.1% (extra-articular: 42.5%, p < 0.0001; intra-articular: 80.3%, p = 0.14) and specificity of 51%. The double contour sign (DCS) was present in 58/61 patients with a positive US study for intra-articular gout (95.1%). CONCLUSIONS:Sensitivity of US for diagnosis of gouty arthritis in hand and wrist is limited, particularly with respect to extra-articular urate deposition. The DCS is the most sensitive sign for the assessment of gouty hand and wrist arthritis by US. KEY POINTS:• Sensitivity of US for diagnosis of gouty arthritis in hand and wrist is limited, particularly with respect to extra-articular gouty deposits. • The double contour sign is the most sensitive finding for the assessment of gouty hand and wrist arthritis by US. • Although the sensitivity of US for diagnosis of gouty hand and wrist arthritis is limited, it can be used as a first-line imaging modality in the presence of the DCS.

journal_name

Eur Radiol

journal_title

European radiology

authors

Klauser AS,Halpern EJ,Strobl S,Abd Ellah MMH,Gruber J,Bellmann-Weiler R,Auer T,Feuchtner G,Jaschke W

doi

10.1007/s00330-018-5363-9

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

4174-4181

issue

10

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-018-5363-9

journal_volume

28

pub_type

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