Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Ultrasound for the diagnosis of gout-the value of gout lesions as defined by the Outcome Measures in Rheumatology ultrasound group

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Which ultrasound lesions contribute to dactylitis in psoriatic arthritis and their reliability in a clinical setting

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Axial involvement in patients with early peripheral spondyloarthritis: a prospective MRI study of sacroiliac joints and spine

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Classification of patients referred under suspicion of tick-borne diseases, Copenhagen, Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: To evaluate ultrasound for diagnosing gout using consensus-based Outcome Measures in Rheumatology ultrasound definitions of gout lesions.

METHODS: Ultrasound was performed in patients with clinically suspected gout. Joints (28) and tendons (26) were binarily evaluated for the Outcome Measures in Rheumatology gout lesions-double contour (DC), tophus, aggregates and erosions. Ultrasound assessment was compared with two reference standards: (i) presence of MSU crystals in joint/tophus aspirate (primary outcome) and (ii) ACR/EULAR 2015 gout classification criteria (secondary outcome). Both reference standards were evaluated by rheumatologists blinded to ultrasound findings. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value of each ultrasound lesion against both reference standards were determined.

RESULTS: Eighty-two patients (70 men), mean age 62.4 (range 19-88) years, were included. Fifty-seven patients were MSU-positive whereas 25 patients were MSU-negative (no MSU crystals: 23; aspiration unsuccessful: 2). Of these 25 patients, three patients were classified as ACR/EULAR-positive (i.e. totally 60 ACR/EULAR-positive patients). All ultrasound lesions had high sensitivities for gout (0.77-0.95). DC and tophus showed high specificities (0.88-0.95), positive predictive values (0.94-0.98) and accuracies (0.82-0.84) when both reference standards were used. In contrast, low specificities were found for aggregates and erosions (0.32-0.59). Ultrasound of MTP joints for DC or tophus, knee joint for DC and peroneus tendons for tophus was sufficient to identify all MSU-positive patients with ultrasound signs of gout at any location.

CONCLUSION: Ultrasound-visualized DC and tophus, as defined by the Outcome Measures in Rheumatology ultrasound group, show high specificities, positive predictive values and accuracies for diagnosing gout and are therefore valid tools in clinical practice.

Original languageEnglish
JournalRheumatology (Oxford, England)
Volume60
Issue number1
Pages (from-to)239-249
Number of pages11
ISSN1462-0324
DOIs
Publication statusPublished - 5 Jan 2021

Bibliographical note

COPECARE

ID: 61649660