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New insights into an old disease: advanced imaging in the diagnosis and management of gout.

Abstract

Advanced imaging modalities including MRI, ultrasound (US), CT and dual energy CT have important applications in gout. While conventional radiography (X-ray) remains the most widely used form of imaging in the clinical setting and is helpful in revealing erosions in chronic gout, these new imaging tools can reveal joint damage and tophi at a much earlier stage. As all are multiplanar techniques, they can define the position and dimensions of tophi, with startling clarity, as well as the size and extent of bone erosions. US and MRI also reveal the severity of inflammation within and adjacent to the joint and can capture information about the composite, vascular nature of many tophaceous deposits. These features can be used as imaging outcome measures, to monitor responses to anti-inflammatory and urate lowering therapies. The new possibility that gout could be diagnosed using imaging, without aspirating the joint, is on the horizon. This review discusses the clinical and research applications of advanced imaging in gout with particular focus on diagnosis and monitoring of joint inflammation and damage.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Molecular Medicine and Pathology, University of Auckland, 85 Park Rd, Grafton, Auckland 1023, New Zealand. f.mcqueen@auckland.ac.nz

    ,

    Source

    Postgraduate medical journal 89:1048 2013 Feb pg 87-93

    MeSH

    Anti-Inflammatory Agents
    Gout
    Gout Suppressants
    Humans
    Magnetic Resonance Imaging
    Tomography, X-Ray Computed
    Ultrasonography

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    23112219

    Citation

    McQueen, Fiona Marion, et al. "New Insights Into an Old Disease: Advanced Imaging in the Diagnosis and Management of Gout." Postgraduate Medical Journal, vol. 89, no. 1048, 2013, pp. 87-93.
    McQueen FM, Reeves Q, Dalbeth N. New insights into an old disease: advanced imaging in the diagnosis and management of gout. Postgrad Med J. 2013;89(1048):87-93.
    McQueen, F. M., Reeves, Q., & Dalbeth, N. (2013). New insights into an old disease: advanced imaging in the diagnosis and management of gout. Postgraduate Medical Journal, 89(1048), pp. 87-93. doi:10.1136/postgradmedj-2012-131000.
    McQueen FM, Reeves Q, Dalbeth N. New Insights Into an Old Disease: Advanced Imaging in the Diagnosis and Management of Gout. Postgrad Med J. 2013;89(1048):87-93. PubMed PMID: 23112219.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - New insights into an old disease: advanced imaging in the diagnosis and management of gout. AU - McQueen,Fiona Marion, AU - Reeves,Quentin, AU - Dalbeth,Nicola, Y1 - 2012/10/30/ PY - 2012/11/1/entrez PY - 2012/11/1/pubmed PY - 2013/7/3/medline SP - 87 EP - 93 JF - Postgraduate medical journal JO - Postgrad Med J VL - 89 IS - 1048 N2 - Advanced imaging modalities including MRI, ultrasound (US), CT and dual energy CT have important applications in gout. While conventional radiography (X-ray) remains the most widely used form of imaging in the clinical setting and is helpful in revealing erosions in chronic gout, these new imaging tools can reveal joint damage and tophi at a much earlier stage. As all are multiplanar techniques, they can define the position and dimensions of tophi, with startling clarity, as well as the size and extent of bone erosions. US and MRI also reveal the severity of inflammation within and adjacent to the joint and can capture information about the composite, vascular nature of many tophaceous deposits. These features can be used as imaging outcome measures, to monitor responses to anti-inflammatory and urate lowering therapies. The new possibility that gout could be diagnosed using imaging, without aspirating the joint, is on the horizon. This review discusses the clinical and research applications of advanced imaging in gout with particular focus on diagnosis and monitoring of joint inflammation and damage. SN - 1469-0756 UR - https://www.unboundmedicine.com/medline/citation/23112219/full_citation L2 - http://pmj.bmj.com/cgi/pmidlookup?view=long&pmid=23112219 DB - PRIME DP - Unbound Medicine ER -