The aims of the current study are to describe
gadolinium-enhanced MRI features of an acute flare of established
gouty arthritis in different joints and to examine a possible association between serum
uric acid and MRI signs indicative of ongoing
inflammation and/or structural joint damage as well as association with disease characteristics and laboratory findings. Twenty-seven male patients with established chronic
gout agreed to participate, mean age 47.6 years, and mean disease duration in months 43.2 (±31.8). For all patients, detailed demographic, disease characteristics, and laboratory findings were obtained and correlated with MRI findings. In 27 patients with established
gout, a total of 50 MRI studies were performed of the following joints: feet joints (n = 23), ankles (n = 18), knees (n = 5), and hand and wrist joints (n = 4). MRI revealed capsular thickening in 19 patients, bone marrow
edema (BME) in 15, soft tissue
edema (STE) in 20, joint effusion in 21, bone erosions in 17, cartilaginous erosions in 4, and
tenosynovitis in 9 cases. In 17 cases, tophaceous lesions were found. Post contrast MRI showed
synovial thickening in seven cases. Positive correlations were observed between serum
uric acid levels and the following MRI findings: capsular thickening (r = 0.552, p = 0.003), BME (r = 0.668, p ≤ 0.0001), STE (r = 0.559, p = 0.002), and
tenosynovitis (r = 0.513, p = 0.006). Using MRI in chronic
gout, important features can be detected like BME, minute cartilaginous erosions, and hypertrophic synovial
inflammation in post contrast MR images. Serum
uric acid (SUA) was positively correlated with capsular thickening, BME, STE, and
tenosynovitis.