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Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

Retrospective longitudinal assessment of the ultrasound gout lesions using the OMERACT semi-quantitative scoring system

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OBJECTIVES: To evaluate responsiveness of gout-specific ultrasound lesions representing urate deposition in patients receiving treat-to-target urate-lowering therapy using a binary and the OMERACT-defined semi-quantitative scoring systems. Furthermore, to determine the most responsive ultrasound measure for urate deposition and the optimal joint/tendon set for monitoring this.

METHODS: Ultrasound (28 joints, 14 tendons) was performed in microscopically verified gout patients initiating/increasing urate-lowering therapy and repeated after 6 and 12 months. Static images/videos of pathologies were stored and scored binarily and semi-quantitatively for tophus, double contour(DC) and aggregates. Lesion-scores were calculated at patient level as were combined crystal sum scores. Responsiveness of lesions-binarily and semi-quantitatively-were calculated at both patient and joint/tendon level.

RESULTS: Sixty-three patients underwent longitudinal evaluation. The static images/videos assessed retrospectively showed statistically significant decreases in tophus and DC, when scored binarily and semi-quantitatively, whereas aggregates were almost unchanged during follow-up. The responsiveness of the semi-quantitative tophus and DC sum scores were markedly higher than those of the binary. The most responsive measure for urate deposition was a combined semi-quantitative tophus-DC-sum score. A feasible joint/tendon set for monitoring included knee and 1st-2nd metatarsophalangeal joints and peroneus and distal patella tendons (all bilateral) representing the most prevalent and responsive sites.

CONCLUSION: The OMERACT consensus-based semi-quantitative ultrasound gout scoring system showed longitudinal validity with both tophus and DC being highly responsive to treatment when assessed in static images/videos. A responsive ultrasound measure for urate deposition and a feasible joint/tendon set for monitoring were proposed and may prove valuable in future longitudinal studies.

OriginalsprogEngelsk
TidsskriftRheumatology (Oxford, England)
ISSN1462-0324
DOI
StatusE-pub ahead of print - 2022

Bibliografisk note

© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

ID: 75715242