Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout?
Objective The primary objective of this prospective case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)-detected abnormalities in the upper and lower limbs in gout. The secondary objective was to test the concurrent validity of US abnorm...
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| Veröffentlicht in: | Annals of the rheumatic diseases 2014-08, Vol.73 (8), p.1522-1528 |
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| creator | Naredo, Esperanza Uson, Jacqueline Jiménez-Palop, Mercedes Martínez, Agustín Vicente, Esther Brito, Elia Rodríguez, Ana Cornejo, Francisco Javier Castañeda, Santos Martínez, María Jesús Sanz, Jesús Möller, Ingrid Batlle-Gualda, Enrique Garrido, Jesús Pascual, Eliseo |
| description | Objective The primary objective of this prospective case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)-detected abnormalities in the upper and lower limbs in gout. The secondary objective was to test the concurrent validity of US abnormalities using as gold standard the microscopic demonstration of monosodium urate (MSU) crystals. Methods Ninety-one men with gout and 42 age-matched controls were prospectively recruited. All patients with gout and controls underwent US assessment of several US abnormalities in 26 joints, six bursae, eight tendons, 20 tendon compartments, four ligaments, and 18 articular cartilages by experts in US blinded to the patients’ group. Patients with gout and controls with US abnormalities were asked to undergo US-guided aspiration for microscopic identification of MSU crystals. Interobserver and intraobserver reliability of the US assessment was evaluated in a web-based exercise. Results The assessment of one joint (ie, radiocarpal joint) for hyperechoic aggregates (HAGs), two tendons (ie, patellar tendon and triceps tendon) for HAGs and three articular cartilages (ie, first metatarsal, talar and second metacarpal/femoral) for double contour sign showed the best balance between sensitivity and specificity (84.6% and 83.3%, respectively). Intraobserver reliability was good (mean κ 0.75) and interobserver reliability was moderate (κ 0.52). The aspirated material from HAGs was positive for MSU crystals in 77.6% of patients with gout and negative in all controls. Conclusions Our results suggest that US bilateral assessment of one joint, three articular cartilages and two tendons may be valid for diagnosing gout with acceptable sensitivity and specificity. |
| doi_str_mv | 10.1136/annrheumdis-2013-203487 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1808665264</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1543283110</sourcerecordid><originalsourceid>FETCH-LOGICAL-b450t-7bf1df2d9903eb83f2239825a5d718980b726e8daea98ede8cff962252ec41c03</originalsourceid><addsrcrecordid>eNqNkU2LFDEQhoO4uOPqX9CAl7205qM7SXsRWdYPWNiLe27SneqZjN3JmEqQvfvDzTCriBeFUOEtnnqp4iXkJWevOZfqjQ0h7aCszmMjGJe1yNboR2TDW2WqUuwx2TDGZNP2Sp-Tp4j7Kpnh5gk5F1KzXrTthvy4W3KyGEtwjYMMUwZH14JTWSJ-hQWyXWhJNgOd0j0elYNDRJ99DG_p952fdnQffchIbXC1YTOdfXA-bJHiLpbF0RGoRYT6HJ1jos7bbageYUu3seR3z8jZbBeE5w__Bbn7cP3l6lNzc_vx89X7m2ZsO5YbPc7czcL1PZMwGjkLIXsjOts5zU1v2KiFAuMs2N6AAzPNc6-E6ARMLZ-YvCCXJ99Dit8KYB5WjxMsiw0QCw7cMKNUJ1T7b7RrpTCS86Prq7_QfSwp1EMGrrWuy9YNKqVP1JQiYoJ5OCS_2nQ_cDYcMx3-yHQ4ZjqcMq2TLx78y7iC-z33K8QKiBMwrvv_dv0JF5ezYg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1777903252</pqid></control><display><type>article</type><title>Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout?</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Naredo, Esperanza ; Uson, Jacqueline ; Jiménez-Palop, Mercedes ; Martínez, Agustín ; Vicente, Esther ; Brito, Elia ; Rodríguez, Ana ; Cornejo, Francisco Javier ; Castañeda, Santos ; Martínez, María Jesús ; Sanz, Jesús ; Möller, Ingrid ; Batlle-Gualda, Enrique ; Garrido, Jesús ; Pascual, Eliseo</creator><creatorcontrib>Naredo, Esperanza ; Uson, Jacqueline ; Jiménez-Palop, Mercedes ; Martínez, Agustín ; Vicente, Esther ; Brito, Elia ; Rodríguez, Ana ; Cornejo, Francisco Javier ; Castañeda, Santos ; Martínez, María Jesús ; Sanz, Jesús ; Möller, Ingrid ; Batlle-Gualda, Enrique ; Garrido, Jesús ; Pascual, Eliseo</creatorcontrib><description>Objective The primary objective of this prospective case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)-detected abnormalities in the upper and lower limbs in gout. The secondary objective was to test the concurrent validity of US abnormalities using as gold standard the microscopic demonstration of monosodium urate (MSU) crystals. Methods Ninety-one men with gout and 42 age-matched controls were prospectively recruited. All patients with gout and controls underwent US assessment of several US abnormalities in 26 joints, six bursae, eight tendons, 20 tendon compartments, four ligaments, and 18 articular cartilages by experts in US blinded to the patients’ group. Patients with gout and controls with US abnormalities were asked to undergo US-guided aspiration for microscopic identification of MSU crystals. Interobserver and intraobserver reliability of the US assessment was evaluated in a web-based exercise. Results The assessment of one joint (ie, radiocarpal joint) for hyperechoic aggregates (HAGs), two tendons (ie, patellar tendon and triceps tendon) for HAGs and three articular cartilages (ie, first metatarsal, talar and second metacarpal/femoral) for double contour sign showed the best balance between sensitivity and specificity (84.6% and 83.3%, respectively). Intraobserver reliability was good (mean κ 0.75) and interobserver reliability was moderate (κ 0.52). The aspirated material from HAGs was positive for MSU crystals in 77.6% of patients with gout and negative in all controls. Conclusions Our results suggest that US bilateral assessment of one joint, three articular cartilages and two tendons may be valid for diagnosing gout with acceptable sensitivity and specificity.</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/annrheumdis-2013-203487</identifier><identifier>PMID: 23709244</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>England: Elsevier Limited</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Agreements ; Arthritis ; Cartilage, Articular - diagnostic imaging ; Cartilage, Articular - metabolism ; Case-Control Studies ; Clinical medicine ; Crystallization ; Disease ; Female ; Gout - complications ; Gout - diagnostic imaging ; Gout - metabolism ; Humans ; Joints - diagnostic imaging ; Joints - metabolism ; Laboratories ; Male ; Metacarpal Bones - diagnostic imaging ; Metacarpal Bones - metabolism ; Metatarsal Bones - diagnostic imaging ; Metatarsal Bones - metabolism ; Middle Aged ; Musculoskeletal Diseases - diagnostic imaging ; Musculoskeletal Diseases - etiology ; Musculoskeletal Diseases - metabolism ; Observer Variation ; Prospective Studies ; Reference Standards ; Reproducibility of Results ; Rheumatism ; Sensitivity and Specificity ; Studies ; Tendons - diagnostic imaging ; Tendons - metabolism ; Ultrasonic imaging ; Ultrasonography - methods ; Ultrasonography - standards ; Ultrasonography - statistics & numerical data ; Uric Acid - chemistry ; Uric Acid - metabolism ; Validity</subject><ispartof>Annals of the rheumatic diseases, 2014-08, Vol.73 (8), p.1522-1528</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2014 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b450t-7bf1df2d9903eb83f2239825a5d718980b726e8daea98ede8cff962252ec41c03</citedby><cites>FETCH-LOGICAL-b450t-7bf1df2d9903eb83f2239825a5d718980b726e8daea98ede8cff962252ec41c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/73/8/1522.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/73/8/1522.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,23551,27903,27904,77347,77378</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23709244$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Naredo, Esperanza</creatorcontrib><creatorcontrib>Uson, Jacqueline</creatorcontrib><creatorcontrib>Jiménez-Palop, Mercedes</creatorcontrib><creatorcontrib>Martínez, Agustín</creatorcontrib><creatorcontrib>Vicente, Esther</creatorcontrib><creatorcontrib>Brito, Elia</creatorcontrib><creatorcontrib>Rodríguez, Ana</creatorcontrib><creatorcontrib>Cornejo, Francisco Javier</creatorcontrib><creatorcontrib>Castañeda, Santos</creatorcontrib><creatorcontrib>Martínez, María Jesús</creatorcontrib><creatorcontrib>Sanz, Jesús</creatorcontrib><creatorcontrib>Möller, Ingrid</creatorcontrib><creatorcontrib>Batlle-Gualda, Enrique</creatorcontrib><creatorcontrib>Garrido, Jesús</creatorcontrib><creatorcontrib>Pascual, Eliseo</creatorcontrib><title>Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout?</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description>Objective The primary objective of this prospective case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)-detected abnormalities in the upper and lower limbs in gout. The secondary objective was to test the concurrent validity of US abnormalities using as gold standard the microscopic demonstration of monosodium urate (MSU) crystals. Methods Ninety-one men with gout and 42 age-matched controls were prospectively recruited. All patients with gout and controls underwent US assessment of several US abnormalities in 26 joints, six bursae, eight tendons, 20 tendon compartments, four ligaments, and 18 articular cartilages by experts in US blinded to the patients’ group. Patients with gout and controls with US abnormalities were asked to undergo US-guided aspiration for microscopic identification of MSU crystals. Interobserver and intraobserver reliability of the US assessment was evaluated in a web-based exercise. Results The assessment of one joint (ie, radiocarpal joint) for hyperechoic aggregates (HAGs), two tendons (ie, patellar tendon and triceps tendon) for HAGs and three articular cartilages (ie, first metatarsal, talar and second metacarpal/femoral) for double contour sign showed the best balance between sensitivity and specificity (84.6% and 83.3%, respectively). Intraobserver reliability was good (mean κ 0.75) and interobserver reliability was moderate (κ 0.52). The aspirated material from HAGs was positive for MSU crystals in 77.6% of patients with gout and negative in all controls. Conclusions Our results suggest that US bilateral assessment of one joint, three articular cartilages and two tendons may be valid for diagnosing gout with acceptable sensitivity and specificity.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Agreements</subject><subject>Arthritis</subject><subject>Cartilage, Articular - diagnostic imaging</subject><subject>Cartilage, Articular - metabolism</subject><subject>Case-Control Studies</subject><subject>Clinical medicine</subject><subject>Crystallization</subject><subject>Disease</subject><subject>Female</subject><subject>Gout - complications</subject><subject>Gout - diagnostic imaging</subject><subject>Gout - metabolism</subject><subject>Humans</subject><subject>Joints - diagnostic imaging</subject><subject>Joints - metabolism</subject><subject>Laboratories</subject><subject>Male</subject><subject>Metacarpal Bones - diagnostic imaging</subject><subject>Metacarpal Bones - metabolism</subject><subject>Metatarsal Bones - diagnostic imaging</subject><subject>Metatarsal Bones - metabolism</subject><subject>Middle Aged</subject><subject>Musculoskeletal Diseases - diagnostic imaging</subject><subject>Musculoskeletal Diseases - etiology</subject><subject>Musculoskeletal Diseases - metabolism</subject><subject>Observer Variation</subject><subject>Prospective Studies</subject><subject>Reference Standards</subject><subject>Reproducibility of Results</subject><subject>Rheumatism</subject><subject>Sensitivity and Specificity</subject><subject>Studies</subject><subject>Tendons - diagnostic imaging</subject><subject>Tendons - metabolism</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography - methods</subject><subject>Ultrasonography - standards</subject><subject>Ultrasonography - statistics & numerical data</subject><subject>Uric Acid - chemistry</subject><subject>Uric Acid - metabolism</subject><subject>Validity</subject><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkU2LFDEQhoO4uOPqX9CAl7205qM7SXsRWdYPWNiLe27SneqZjN3JmEqQvfvDzTCriBeFUOEtnnqp4iXkJWevOZfqjQ0h7aCszmMjGJe1yNboR2TDW2WqUuwx2TDGZNP2Sp-Tp4j7Kpnh5gk5F1KzXrTthvy4W3KyGEtwjYMMUwZH14JTWSJ-hQWyXWhJNgOd0j0elYNDRJ99DG_p952fdnQffchIbXC1YTOdfXA-bJHiLpbF0RGoRYT6HJ1jos7bbageYUu3seR3z8jZbBeE5w__Bbn7cP3l6lNzc_vx89X7m2ZsO5YbPc7czcL1PZMwGjkLIXsjOts5zU1v2KiFAuMs2N6AAzPNc6-E6ARMLZ-YvCCXJ99Dit8KYB5WjxMsiw0QCw7cMKNUJ1T7b7RrpTCS86Prq7_QfSwp1EMGrrWuy9YNKqVP1JQiYoJ5OCS_2nQ_cDYcMx3-yHQ4ZjqcMq2TLx78y7iC-z33K8QKiBMwrvv_dv0JF5ezYg</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Naredo, Esperanza</creator><creator>Uson, Jacqueline</creator><creator>Jiménez-Palop, Mercedes</creator><creator>Martínez, Agustín</creator><creator>Vicente, Esther</creator><creator>Brito, Elia</creator><creator>Rodríguez, Ana</creator><creator>Cornejo, Francisco Javier</creator><creator>Castañeda, Santos</creator><creator>Martínez, María Jesús</creator><creator>Sanz, Jesús</creator><creator>Möller, Ingrid</creator><creator>Batlle-Gualda, Enrique</creator><creator>Garrido, Jesús</creator><creator>Pascual, Eliseo</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20140801</creationdate><title>Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout?</title><author>Naredo, Esperanza ; Uson, Jacqueline ; Jiménez-Palop, Mercedes ; Martínez, Agustín ; Vicente, Esther ; Brito, Elia ; Rodríguez, Ana ; Cornejo, Francisco Javier ; Castañeda, Santos ; Martínez, María Jesús ; Sanz, Jesús ; Möller, Ingrid ; Batlle-Gualda, Enrique ; Garrido, Jesús ; Pascual, Eliseo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b450t-7bf1df2d9903eb83f2239825a5d718980b726e8daea98ede8cff962252ec41c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Agreements</topic><topic>Arthritis</topic><topic>Cartilage, Articular - diagnostic imaging</topic><topic>Cartilage, Articular - metabolism</topic><topic>Case-Control Studies</topic><topic>Clinical medicine</topic><topic>Crystallization</topic><topic>Disease</topic><topic>Female</topic><topic>Gout - complications</topic><topic>Gout - diagnostic imaging</topic><topic>Gout - metabolism</topic><topic>Humans</topic><topic>Joints - diagnostic imaging</topic><topic>Joints - metabolism</topic><topic>Laboratories</topic><topic>Male</topic><topic>Metacarpal Bones - diagnostic imaging</topic><topic>Metacarpal Bones - metabolism</topic><topic>Metatarsal Bones - diagnostic imaging</topic><topic>Metatarsal Bones - metabolism</topic><topic>Middle Aged</topic><topic>Musculoskeletal Diseases - diagnostic imaging</topic><topic>Musculoskeletal Diseases - etiology</topic><topic>Musculoskeletal Diseases - metabolism</topic><topic>Observer Variation</topic><topic>Prospective Studies</topic><topic>Reference Standards</topic><topic>Reproducibility of Results</topic><topic>Rheumatism</topic><topic>Sensitivity and Specificity</topic><topic>Studies</topic><topic>Tendons - diagnostic imaging</topic><topic>Tendons - metabolism</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography - methods</topic><topic>Ultrasonography - standards</topic><topic>Ultrasonography - statistics & numerical data</topic><topic>Uric Acid - chemistry</topic><topic>Uric Acid - metabolism</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Naredo, Esperanza</creatorcontrib><creatorcontrib>Uson, Jacqueline</creatorcontrib><creatorcontrib>Jiménez-Palop, Mercedes</creatorcontrib><creatorcontrib>Martínez, Agustín</creatorcontrib><creatorcontrib>Vicente, Esther</creatorcontrib><creatorcontrib>Brito, Elia</creatorcontrib><creatorcontrib>Rodríguez, Ana</creatorcontrib><creatorcontrib>Cornejo, Francisco Javier</creatorcontrib><creatorcontrib>Castañeda, Santos</creatorcontrib><creatorcontrib>Martínez, María Jesús</creatorcontrib><creatorcontrib>Sanz, Jesús</creatorcontrib><creatorcontrib>Möller, Ingrid</creatorcontrib><creatorcontrib>Batlle-Gualda, Enrique</creatorcontrib><creatorcontrib>Garrido, Jesús</creatorcontrib><creatorcontrib>Pascual, Eliseo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Naredo, Esperanza</au><au>Uson, Jacqueline</au><au>Jiménez-Palop, Mercedes</au><au>Martínez, Agustín</au><au>Vicente, Esther</au><au>Brito, Elia</au><au>Rodríguez, Ana</au><au>Cornejo, Francisco Javier</au><au>Castañeda, Santos</au><au>Martínez, María Jesús</au><au>Sanz, Jesús</au><au>Möller, Ingrid</au><au>Batlle-Gualda, Enrique</au><au>Garrido, Jesús</au><au>Pascual, Eliseo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout?</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>73</volume><issue>8</issue><spage>1522</spage><epage>1528</epage><pages>1522-1528</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract>Objective The primary objective of this prospective case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)-detected abnormalities in the upper and lower limbs in gout. The secondary objective was to test the concurrent validity of US abnormalities using as gold standard the microscopic demonstration of monosodium urate (MSU) crystals. Methods Ninety-one men with gout and 42 age-matched controls were prospectively recruited. All patients with gout and controls underwent US assessment of several US abnormalities in 26 joints, six bursae, eight tendons, 20 tendon compartments, four ligaments, and 18 articular cartilages by experts in US blinded to the patients’ group. Patients with gout and controls with US abnormalities were asked to undergo US-guided aspiration for microscopic identification of MSU crystals. Interobserver and intraobserver reliability of the US assessment was evaluated in a web-based exercise. Results The assessment of one joint (ie, radiocarpal joint) for hyperechoic aggregates (HAGs), two tendons (ie, patellar tendon and triceps tendon) for HAGs and three articular cartilages (ie, first metatarsal, talar and second metacarpal/femoral) for double contour sign showed the best balance between sensitivity and specificity (84.6% and 83.3%, respectively). Intraobserver reliability was good (mean κ 0.75) and interobserver reliability was moderate (κ 0.52). The aspirated material from HAGs was positive for MSU crystals in 77.6% of patients with gout and negative in all controls. Conclusions Our results suggest that US bilateral assessment of one joint, three articular cartilages and two tendons may be valid for diagnosing gout with acceptable sensitivity and specificity.</abstract><cop>England</cop><pub>Elsevier Limited</pub><pmid>23709244</pmid><doi>10.1136/annrheumdis-2013-203487</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0003-4967 |
| ispartof | Annals of the rheumatic diseases, 2014-08, Vol.73 (8), p.1522-1528 |
| issn | 0003-4967 1468-2060 |
| language | eng |
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| source | MEDLINE; BMJ Journals - NESLi2 |
| subjects | Adult Aged Aged, 80 and over Agreements Arthritis Cartilage, Articular - diagnostic imaging Cartilage, Articular - metabolism Case-Control Studies Clinical medicine Crystallization Disease Female Gout - complications Gout - diagnostic imaging Gout - metabolism Humans Joints - diagnostic imaging Joints - metabolism Laboratories Male Metacarpal Bones - diagnostic imaging Metacarpal Bones - metabolism Metatarsal Bones - diagnostic imaging Metatarsal Bones - metabolism Middle Aged Musculoskeletal Diseases - diagnostic imaging Musculoskeletal Diseases - etiology Musculoskeletal Diseases - metabolism Observer Variation Prospective Studies Reference Standards Reproducibility of Results Rheumatism Sensitivity and Specificity Studies Tendons - diagnostic imaging Tendons - metabolism Ultrasonic imaging Ultrasonography - methods Ultrasonography - standards Ultrasonography - statistics & numerical data Uric Acid - chemistry Uric Acid - metabolism Validity |
| title | Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T02%3A18%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ultrasound-detected%20musculoskeletal%20urate%20crystal%20deposition:%20which%20joints%20and%20what%20findings%20should%20be%20assessed%20for%20diagnosing%20gout?&rft.jtitle=Annals%20of%20the%20rheumatic%20diseases&rft.au=Naredo,%20Esperanza&rft.date=2014-08-01&rft.volume=73&rft.issue=8&rft.spage=1522&rft.epage=1528&rft.pages=1522-1528&rft.issn=0003-4967&rft.eissn=1468-2060&rft.coden=ARDIAO&rft_id=info:doi/10.1136/annrheumdis-2013-203487&rft_dat=%3Cproquest_cross%3E1543283110%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1777903252&rft_id=info:pmid/23709244&rfr_iscdi=true |