The role of ultrasonography in imaging of gouty arthritis

Abstract

Gouty arthritis: overview Gouty arthritis is the most common form of inflammatory arthritis in the USA affecting 8.3 million US citizens [1]. Gouty arthritis is caused by monosodium urate (MSU) crystal deposition within joints and soft tissues resulting from hyperuricemia [2]. Above serum urate (SU) levels of 6.8 mg/dl, MSU crystals fall out of solution and deposit in joints and soft tissues. MSU crystal deposition can lead to inflammation and result in an acute gouty arthritis attack manifesting as extreme pain, tenderness, warmth, swelling, erythema, and loss of function of the affected joint or joints [3,4]. It has recently become clear that during the intercritical period, when the patient is asymptomatic, chronic inflammation is often present [5]. If MSU crystal deposition and chronic inflammation persist, recurrent acute attacks may increase in frequency and severity [4], and a chronic destructive gouty arthritis characterized by disfiguring tophi, joint destruction and persistent pain may ensue.