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Highly Accessed Review

Gout. Imaging of gout: findings and utility

Fernando Perez-Ruiz1*, Nicola Dalbeth2, Aranzazu Urresola3, Eugenio de Miguel4 and Naomi Schlesinger5

Author Affiliations

1 Rheumatology Division, Hospital de Cruces, Pza. Cruces sn 48903, Baracaldo, Vizcaya, Spain

2 Department of Medicine, University of Auckland, 85 Park Rd, Garfton, New Zealand

3 Radiology Division, Hospital de Cruces, Pza. Cruces sn 48903, Baracaldo, Vizcaya, Spain

4 Rheumatology Division, Hospital La Paz, 28034 Madrid, Spain

5 Division of Rheumatology, Department of Medicine, UMDNJ – Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA

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Arthritis Research & Therapy 2009, 11:232  doi:10.1186/ar2687

Published: 17 June 2009

Abstract

Imaging is a helpful tool for clinicians to evaluate diseases that induce chronic joint inflammation. Chronic gout is associated with changes in joint structures that may be evaluated with diverse imaging techniques. Plain radiographs show typical changes only in advanced chronic gout. Computed tomography may best evaluate bone changes, whereas magnetic resonance imaging is suitable to evaluate soft tissues, synovial membrane thickness, and inflammatory changes. Ultrasonography is a tool that may be used in the clinical setting, allowing evaluation of cartilage, soft tissues, urate crystal deposition, and synovial membrane inflammation. Also ultrasound-guided puncture may be useful for obtaining samples for crystal observation. Any of these techniques deserve some consideration for feasibility and implementation both in clinical practice and as outcome measures for clinical trials. In clinical practice they may be considered mainly for evaluating the presence and extent of crystal deposition, and structural changes that may impair function or functional outcomes, and also to monitor the response to urate-lowering therapy.