Musculoskeletal ultrasonographic assessment of asymptomatic hyperuricemic Egyptian individuals

• Published in: Egyptian Rheumatology and Rehabilitation 2013, Vol.40 (2), p.88-95
• Main Authors: Yunus, Taqawah B., al-Attar, Inas A., Eliab, Rimun Z., Abu al-Hamayed, Hazim F.
• Format: Article
• Language: English
• Subjects: Diagnosis; Diseases; Hyperuricemia; Medicine & Public Health; Musculoskeletal system; Original Article; Rehabilitation; Ultrasonic imaging; الأمراض; التشخيص; العضلات
• ISSN: 1110-161X; 2090-3235
• DOI: 10.7123/01.ERR.0000426389.17626.FE

Background Asymptomatic hyperuricemic individuals are discovered accidently on the basis of elevated levels of serum urate. The established use of urate-lowering treatment in patients with gouty arthritis is well documented; however, it is still an issue of research and controversy in individuals with asymptomatic hyperuricemia. Therefore, many attempts have been made to study the influence of asymptomatic hyperuricemia on different musculoskeletal organs. Objectives The aim of this study was to view the ultrasonographic musculoskeletal changes in asymptomatic hyperuricemic individuals and to compare them with the findings in normal controls. Methods Bilateral ultrasonographic examinations of the first metatarsal–phalangeal joints, ankles and knees, as well as of the related tendons and enthesis of the lower limbs, for 40 asymptomatic hyperuricemic individuals and 40 normal controls, were performed. Results A double contour sign was found at the first metatarsal–phalangeal joint in 45% of joints of hyperuricemic individuals but was absent in controls (Po0.001). It was also found in the femoral cartilage in 15% of knees of hyperuricemic individuals but was absent in controls (Po0.0001). Patellar tendenopathy was recorded in 6.25% of tendons. Intratendinous tophi were significantly reported in the patellar and Achilles tendons of patients. Achilles enthesopathy was reported in 18.75% of tendons of patients compared with 2.5% of tendons of controls (Po0.001). Intra-articular tophi were reported in 16 ankle joints (20%) of hyperuricemic individuals but were absent in controls (Po0.001). Conclusion Musculoskeletal ultrasonography of asymptomatic hyperuricemic individuals helps identify morphostructural changes suggestive of gouty arthritis induced by chronic hyperuricemia occurring in both intra-articular and extra-articular structures.