Ultrasonographic detection of double contour sign and hyperechoic aggregates for diagnosis of gout: two sites examination is as good as six sites examination

• Published in: International journal of rheumatic diseases 2018-02, Vol.21 (2), p.523-531
• Main Authors: Bhadu, Danveer, Das, Siddharth K., Wakhlu, Archana, Dhakad, Urmila, Sharma, Meha
• Format: Article
• Language: English
• Subjects: Adult; Ankle Joint - diagnostic imaging; Biomarkers - blood; Cartilage (articular); Cartilage, Articular - diagnostic imaging; double contour sign; Female; Femur; Gout; Gout - blood; Gout - diagnostic imaging; Humans; hyperechoic aggregates; Knee; Knee Joint - diagnostic imaging; Male; Metatarsophalangeal Joint - diagnostic imaging; Metatarsus; Middle Aged; Patellar Ligament - diagnostic imaging; Predictive Value of Tests; Reproducibility of Results; Rheumatism; Skin & tissue grafts; Ultrasonography; Ultrasound; Uric acid; Uric Acid - blood; Wrist Joint - diagnostic imaging
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.13235

Objective To compare ultrasound‐detected abnormalities, namely double contour sign (DCS) and hyperechoic aggregates (HAGs), at two sites (knee and first metatarsophalangeal [1st MTP] joints) versus six sites (knee joint, 1st MTP joint, radiocarpal joint, talar joint, patellar tendon and triceps tendon) in gout patients. Methods Forty‐seven clinically diagnosed gout patients and 50 subjects (serum uric acid < 7 mg/dL) as controls were included. DCS was looked for at three articular cartilage sites (first metatarsal, tibiotalar and femoral condyle), whereas HAGs were looked for at one joint site (radiocarpal joint) and two tendon sites (patellar tendon and triceps tendon). Ultrasound findings of both the groups were compared. Results Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and positive likelihood ratio (LR) of two sites ultrasound findings for gout were 87.2%, 84%, 83.7%, 85.6% and 5.5 respectively. Similar sensitivity, specificity, PPV, NPV and positive LR were observed with six sites ultrasound findings. Among controls, 16% were found to have these abnormal ultrasound findings by both two sites and six sites examinations. Conclusion Screening of two sites (knee and 1st MTP) has similar sensitivity, specificity, PPV, NPV and positive LR as compared to six sites in diagnosing gout.