Gout Imaging
Preferred examination Plain film radiography may be used to evaluate gout; however, radiographic…
emedicine.medscape.com
The confirmatory diagnostic test for gout is demonstrating monosodium urate crystals engulfed by white blood cells in the aspirate from an inflamed joint.
This is not always available, nor often necessary (especially if the clinical presentation is classical). In such cases where the diagnosis is suspected but in doubt, the best alternative is imaging.
Relationship of bone erosion with the urate and soft tissue components of the tophus in gout: a dual energy computed tomography study
Crystals Prevalent in AS without Gout
Crystal deposition at sacroiliac joints linked with radiographic progression
medpagetoday.com
Gout, as “king of diseases”, is a great mimicker.
Might some of these “Axial Spondyloarthritis” cases, especially those without syndesmophytes or ankylosis, be actually misdiagnosed Gout?
Gout is by far the most common inflammatory arthritis. Should those diagnosed with RA, AS or PsA (or even rarer conditions like adult Still’s, RS3PE, etc) present atypically or fail to respond to appropriate immunomodulation, it should prompt evaluation for possible Gout as an alternative or concomitant diagnosis.
Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study
