Abstract
Gout, a crystalline arthropathy caused by the deposition of monosodium urate crystals in the articular and periarticular soft tissues, is a frequent cause of painful arthropathy. Imaging has an important role in the initial evaluation as well as the treatment and follow up of gouty arthropathy. The imaging findings of gouty arthropathy on radiography, ultrasonography, computed tomography, dual energy computed tomography, and magnetic resonance imaging are described to include findings of the early, acute and chronic phases of gout. These findings include early monosodium urate deposits, osseous erosions, and tophi, which may involve periarticular tissues, tendons, and bursae. Treatment of gout includes non-steroidal anti-inflammatories, colchicine, glucocorticoids, interleukin-1 inhibitors, xanthine oxidase inhibitors, uricosuric drugs, and recombinant uricase. Imaging is critical in monitoring response to therapy; clinical management can be modulated based on imaging findings. This review article describes the current standard of care in imaging and treatment of gouty arthropathy.
Highlights
Chrong-Reen Wang, Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA; Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
Imaging has an important role in the initial evaluation, differential diagnosis, and the treatment follow-up of gouty arthropathy
US and magnetic resonance imaging (MRI) can detect resolving joint effusions and synovitis [15]. Imaging shows both the soft-tissue and osseous changes that occur in gout secondary to inflammatory changes from the deposition of monosodium urate (MSU) crystals
Summary
Gout is the most common cause of inflammatory arthritis in adults [1,2,3,4,5,6,7,8,9,10,11,12,13]. Med. 2022, 11, 166 tomography (CT) (both conventional and dual energy computed tomography (DECT)), and magnetic resonance imaging (MRI) (Figures 2–14) are described, to include findings of the early, acute and chronic phases of gout These findings include early MSU crystal deposits as well as later osseous erosions and tophi, which may involve periarticular tissues, tendons, and bursae. The imaging findings of gouty arthropathy on radiography, ultrasonography (US), computed tomography (CT) (both conventional and dual energy computed tomography (DECT)), and magnetic resonance imaging (MRI) (Figures 2–14) are described, to include findings of the early, acute and chronic phases of gout
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