Use of ultrasound for diagnosis and monitoring of outcomes in crystal arthropathies.

Abstract

PURPOSE OF REVIEW:

In the latest recommendations for the diagnosis and management of gout and calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, the diagnostic potential of ultrasound has been recognized. This review highlights the recent advances of research on ultrasound in gout and CPPD crystal deposition disease.

RECENT FINDINGS:

Ultrasound allows highly sensitive, noninvasive and quick detection of microcrystal aggregates in multiple anatomic areas. Ultrasound can be used as a safe and reliable guide to aspirate even minimal fluid collections suitable for microscopic analysis, and as a tool for monitoring monosodium urate crystal dissolution induced by urate-lowering therapy. The first metatarsophalangeal joint and the knee should be regarded as the anatomic regions with the highest probability of being respectively positive for monosodium urate and CPPD crystal aggregates.

SUMMARY:

The detection of highly evocative signs in patients with equivocal clinical findings may have a deep impact on the clinical decision-making process, narrowing the differential diagnostic spectrum and avoiding time-consuming and expensive diagnostic procedures. Ultrasound differential diagnosis between gout and CPPD crystal deposition disease is based on the characteristics of crystal aggregates and their preferential localization in different anatomical areas.

• Authors: Walter Grassi, Tadashi Okano, Emilio Filippucci
• Journal: Current opinion in rheumatology (Curr Opin Rheumatol) Vol. 27 Issue 2 Pg. 147-55 (Mar 2015) ISSN: 1531-6963 [Electronic] United States
• PMID: 25633243 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Topics

• Chondrocalcinosis (diagnostic imaging, drug therapy)
• Diagnosis, Differential
• Drug Monitoring (methods)
• Gout (diagnostic imaging, drug therapy)
• Humans
• Knee Joint (diagnostic imaging)
• Metatarsophalangeal Joint (diagnostic imaging)
• Treatment Outcome
• Ultrasonography