Abstract
Gout and pseudogout are crystal-related diseases secondary to a metabolic disorder. The consequences are: (i) deposition in joints, synovium and tendons and (ii) possibility of inflammatory arthritis. The gold standard for diagnosis is the visualization by optic microscopy of crystals in synovial fluid. However, diagnosis is sometimes difficult and imaging can help the physician to diagnose this diseases. Radiography is not sensitive in early gout and sometimes normal in pseudogout. Thus, ultrasonography (US) might appear as a useful tool in the management of these diseases. In gout, two US features are specific: the double contour sign and aggregates evocating of tophus. Moreover, these signs can disappear under efficient urate lowering therapy. In pseudogout, the interest of US is mainly for the diagnosis by direct visualization of calcifications in hyaline cartilage and fibrocartilage. In pseudogout, US is more sensitive than radiography to detect these calcifications. In summary, US appears to be useful for diagnosis and management of these two crystal-related diseases.
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