SP0067\u2005HOW TO ASSESS US LESIONS FOR GOUT + DEMO

Abstract

Gout is the most common inflammatory joint disease in Western developed countries. Diagnosis and monitoring have historically been based upon clinical assessment combined with biochemical results (primarily p-urate) but over the last decade ultrasonography (US) has received increasing attention for these purposes. US has been shown able to detect monosodium urate deposits in both joints and tendons. In 2015 the Outcome Measures in Rheumatology (OMERACT) US Working Group developed definitions of structural lesions in gout. These include double contour sign (deposits of crystals on the surface of cartilage), tophus (larger hyper-echoic aggregation of crystals), aggregates (small hyper-echoic deposits) and erosion (1). The double contour sign has been included in the ACR/EULAR 2015 gout classification criteria as a way to visualize urate deposits in joints (2). Furthermore, US can visualize potential concomitant inflammatory aspects of gout since it can visualize both joint inflammation and tenosynovitis. In this talk the diagnostic properties of US will be described and the potential risk of false positive results due to artefacts or misinterpreted lesions will be discussed. Furthermore, the potential role of US in monitoring of treatment response will be explored. References: [1] Gutierrez M, Schmidt WA, Thiele RG, Keen HI, Kaeley GS, Naredo E, Iagnocco A, Bruyn GA, Balint PV, Filippucci E, Mandl P, Kane D, Pineda C, Delle Sedie A, Hammer HB, Christensen R, D”Agostino MA, Terslev L; OMERACT Ultrasound Gout Task Force group. International Consensus for ultrasound lesions in gout: results of Delphi process and web-reliability exercise. Rheumatology (Oxford). 2015;54(10):1797-805. [2] Neogi T, Jansen TLTA, Dalbeth N, Fransen J, Schumacher HR, et al. 2015 Gout Classification criteria: an American College of Rheumatology/European Leaque Against Rheumatisme collaborative initiative. Ann Rheum Diss 2015; 74: 1789-1798. Disclosure of Interests: None declared