Research On The Correlation Between Ultrasound Scoring System And Serum Uric Acid,Disease Course And Inflammation Indicators For Gouty Arthritis

Objective:To study the correlation between ultrasonic findings of lesions and serum uric acid,course of gouty arthritis by using musculoskeletal ultrasound scoring system in gouty arthritis.And analyzing whether there is correlation between laboratory inflammation indicators and ultrasonic synovitis activity,so as to evaluate the clinical value of musculoskeletal ultrasound scoring system in gouty arthritis.Methods:A total of 94 patients with primary gouty arthritis in our hospital were enrolled in our study,and divided into three groups according to the course of disease:group A:18 patients whose course were less than 3 years,group B:30 patients whose course were for 3-5 years,group C:46 patients whose course were more than 5 years.The patients were examined by ultrasonography of lower extremity joints and inflammatory related blood indexes.We scored on the basis of the ultrasound findings of the joint to analyze the correlation between ultrasound scoring system and serum uric acid,disease course and inflammatory related blood indexes for gouty arthritis,and to compare the difference of ultrasonic score among the groups.Results:(1)There was no significant correlation between the level of serum uric acid and ultrasonic score and total scores of double-contour sign,cloud sign,snowstorm sign,Intratendon hyperecho,tophus,erosion(P>0.05).(2)There was a significant correlation between the ultrasonic scores and total scores of double-contour sign,cloud sign,intratendon hyperecho,tophus,erosion and the course of the disease(P<0.05),but there was no significant correlation between snowstorm sign and the duration of the disease(P>0.05).(3)There was a significant correlation between the synovial thickness score and ESR(P<0.05),but there was no significant correlation between the ultrasonic synovial thickness score and the number of white blood cells,the absolute value of neutrophils and high sensitivity C-reactive protein(P>0.05).(4)There was no significant correlation between synovial blood flow score and leukocyte count,neutrophil absolute value,ESR and hs-CRP(P>0.05).(5)There were significant differences in the four ultrasound scores and total scores of double-contour sign,cloud sign,tophus,erosion among the three groups(P<0.05),but there were no significant differences in the snowstorm sign and intratendon hyperechoic ultrasound scores(P>0.05).Conclusions:There is no correlation between serum uric acid and urate deposition in gout patients.It is impossible to directly reflect the joint and tendon involvement of gout arthritis by serum uric acid alone.Synovial thickness in articular cavity is correlated with ESR,which suggests that proliferative synovium can be used to judge the activity of gouty arthritis.Ultrasound score can quantify the severity of gouty arthritis lesions,prompt the progress of lesions,and directly reflect the deposition of urate,which can provide reference for clinical diagnosis.