Objective: To observe the characteristic features of musculoskeletal ultrasound (MSUS) in gouty arthritis (GA) and to assess its value in GA diagnosis.
Methods: Patients with GA and non-GA who underwent MSUS examination in Chinese PLA General Hospital were enrolled in this study. The synovitis, tenosynovitis, soft tissue swelling, bone erosion, bursitis and ossification were measured by grey-scale ultrasound, and the synovial vascularity was measured by power Doppler ultrasound to evaluate the degree of inflammation.
Results: The ultrasound images of GA were intended to have specific features like tophus, hyperechoic deposition on the surface of the articular hyaline cartilage (double contour sign), hyperechoic deposition in the synovium appearing as bright stippled foci, and bright strap in tendons with a significant difference when compared with non-GA group (P < 0.05). The percentage of tenosynovitis and bone erosion in non-GA group was higher than that in the GA group with a significant difference (P < 0.05). Tophus, double contour sign, bright stippled foci or bright stippled foci in tendons together suggested gout with a specificity of 92.4% and a sensitivity of 60.3%, the AUC of ROC was 0.764 (P < 0.05).
Conclusion: Tophus, double contour sign, bright foci and bright strap detected by MSUS are of diagnostic value on GA and MSUS may be a promising tool in diagnosing GA.