The Diagnostic Value Of High Frequency Ultrasound And DECT In Asymptomatic Hyperuricemia And Gouty Arthritis

Objective To explore the joints and tendons characteristic features of highfrequency ultrasound in asymptomatic hyperuricemia(AH) and to assess its value inAH diagnosis.Method One hundred asymptomatic individuals with hyperuricemia (AH group)and75normouricemic subjects (control group) were examined by high frequency andcolor doppler ultrasound. The joints, tendons and soft tissue of the knees, ankles andfirst metatarsal-phalangeal joints in these two groups were examined. Thecorrelations of serum urate(SU) level with double contour sign, bone erosion andarticular cavity effusion were analysed.Results Hyperechoic deposition on the sulface of the articular hyaline cartilage(double contour sign) were found in the knees(37), ankles(17) and the first MTPJs(48)from the asymptomatic individuals with hyperuricemia, in contrast to none in thecontrol group (P <0.05). Similar results were found in these two groups of the boneerosion (32,26,20vs5,6,3, P <0.05), the effusion (28,36,41vs6,8,9, P <0.05) andthe hyperechoic spots (19,18,22vs0,0,0, P <0.05); Patellar enthesopathy (4.5%vs0.6%, P <0.05) as well as Achilles enthesopathy(8%vs0, P <0.05) and Achillestophi (6%vs0.6%, P <0.05) were more frequent in asymptomatic hyperuricemicthan that of normouricemic individuals. No correlations between SU concentrationand the presence of the double contour sign, the bone erosion and effusion were found(P>0.05).Conclusion There were some similar specific sonographic findings of goutyarthritis in the asymptomatic individuals with hyperuricemia. Also, these findingssupport high frequency ultrasound as a useful tool to detect anatomical damage in thejoints, synovial tissue and tendons of asymptomatic individuals with hyperuricemia. Objective To compare the value of high frequency ultrasound and DECT indiagnosis of gouty arthritis(GA).Method33patients with GA altogether157jionts and18patients with non-GAaltogether100jionts were examined with the high frequency ultrasound and DECT.The monosodium urate,bone erosion, effusion，synovial thickening of GA wereobserved by high frequency ultrasound and DECT,and the synovial vascularity wasmeasured by color doppler ultrasound to evaluate the degree of inflammation.Results The sensitivity, specificity, accuracy, positive predictive and negativepredictive of high frequency ultrasound were77.7%,93.0%,83.7%,94.6%and72.7%, while DECT were87.9%,97.0%,91.4%,97.9%and83.6%, respectively.There was no significant difference between sensitivity, specificity, accuracy, positivepredictive and negative predictive of these two methods(p>0.05). But the areas underthe curves(AUC) of high frequency ultrasound and DECT were0.933and0.854,respectively. There was significant difference between the two methods ofAUC(P<0.05). The monosodium urate (122vs138), bone erosion (98vs103),effusion (60vs55), were found in GA group by high frequency ultrasound andDECT. There was medium, good and better consistency of these two methods（0.561,0.738,0.816,p <0.05）. The synovial thickening of GA were22whounderwent high frequency ultrasound while DECT can not measure the synovialthickening.Conclusion Both high frequency ultrasound and DECT are helpful in the evaluationof GA, but DECT has higher value in the diagnosis of monosodium urate.