Display options
Share it on

J Clin Med. 2021 Dec 29;11(1). doi: 10.3390/jcm11010166.

Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging.

Journal of clinical medicine

Jennifer S Weaver, Ernest R Vina, Peter L Munk, Andrea S Klauser, Jamie M Elifritz, Mihra S Taljanovic

Affiliations

  1. Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA.
  2. Department of Medicine, University of Arizona Arthritis Center, Tucson, AZ 85724, USA.
  3. Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
  4. Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada.
  5. Radiology Department, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
  6. Departments of Radiology and Pathology, University of New Mexico, Albuquerque, NM 87131, USA.
  7. New Mexico Office of the Medical Investigator, Albuquerque, NM 87131, USA.
  8. Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85721, USA.

PMID: 35011907 PMCID: PMC8745871 DOI: 10.3390/jcm11010166

Abstract

Gout, a crystalline arthropathy caused by the deposition of monosodium urate crystals in the articular and periarticular soft tissues, is a frequent cause of painful arthropathy. Imaging has an important role in the initial evaluation as well as the treatment and follow up of gouty arthropathy. The imaging findings of gouty arthropathy on radiography, ultrasonography, computed tomography, dual energy computed tomography, and magnetic resonance imaging are described to include findings of the early, acute and chronic phases of gout. These findings include early monosodium urate deposits, osseous erosions, and tophi, which may involve periarticular tissues, tendons, and bursae. Treatment of gout includes non-steroidal anti-inflammatories, colchicine, glucocorticoids, interleukin-1 inhibitors, xanthine oxidase inhibitors, uricosuric drugs, and recombinant uricase. Imaging is critical in monitoring response to therapy; clinical management can be modulated based on imaging findings. This review article describes the current standard of care in imaging and treatment of gouty arthropathy.

Keywords: CT; crystalline arthropathy; dual energy CT; gout; imaging; magnetic resonance imaging; monosodium urate crystals; radiography; sonography; treatment

References

  1. J Rheumatol. 2005 Dec;32(12):2485-7 - PubMed
  2. Rheumatology (Oxford). 2021 Oct 2;60(10):4855-4860 - PubMed
  3. Clin Exp Rheumatol. 2017 Sep-Oct;35(5):746-751 - PubMed
  4. Ann Rheum Dis. 2020 Nov;79(11):1500-1505 - PubMed
  5. N Engl J Med. 2005 Dec 8;353(23):2450-61 - PubMed
  6. Clin Nucl Med. 2000 Feb;25(2):146-7 - PubMed
  7. Lancet. 2008 May 31;371(9627):1854-60 - PubMed
  8. Rheumatology (Oxford). 2021 Jul 10;: - PubMed
  9. Arthritis Rheum. 2007 Feb 15;57(1):109-15 - PubMed
  10. Semin Arthritis Rheum. 2020 Jun;50(3S):S11-S16 - PubMed
  11. Cochrane Database Syst Rev. 2014 Sep 16;(9):CD010120 - PubMed
  12. Arthritis Res Ther. 2021 Jul 9;23(1):185 - PubMed
  13. Ann Rheum Dis. 2018 Mar;77(3):364-370 - PubMed
  14. Rheumatol Int. 2010 Feb;30(4):495-503 - PubMed
  15. Front Immunol. 2019 Mar 04;10:266 - PubMed
  16. Ultrasonography. 2021 Apr;40(2):197-206 - PubMed
  17. Rheumatol Int. 2018 Aug;38(8):1339-1344 - PubMed
  18. Rheumatology (Oxford). 2009 Nov;48(11):1442-6 - PubMed
  19. Arthritis Care Res (Hoboken). 2011 Oct;63(10):1456-62 - PubMed
  20. Eur Radiol. 2019 Mar;29(3):1267-1275 - PubMed
  21. Mod Rheumatol. 2017 May;27(3):518-523 - PubMed
  22. J Rheumatol. 2009 Oct;36(10):2342-5 - PubMed
  23. Clin Med (Lond). 2017 Feb;17(1):54-59 - PubMed
  24. Skeletal Radiol. 2014 Mar;43(3):277-81 - PubMed
  25. JAMA Cardiol. 2019 Oct 1;4(10):1019-1028 - PubMed
  26. Radiology. 2011 Nov;261(2):516-24 - PubMed
  27. Semin Arthritis Rheum. 2006 Dec;36(3):197-202 - PubMed
  28. Ann Acad Med Singap. 2020 Nov;49(11):931-933 - PubMed
  29. AJR Am J Roentgenol. 2010 Apr;194(4):1072-8 - PubMed
  30. Acta Biomed. 2020 Jul 13;91(8-S):116-124 - PubMed
  31. Clin Rheumatol. 2022 Jan;41(1):223-233 - PubMed
  32. Arthritis Res Ther. 2011 Jan 17;13(1):R4 - PubMed
  33. Semin Arthritis Rheum. 2009 Jun;38(6):411-9 - PubMed
  34. Semin Arthritis Rheum. 2019 Feb;48(4):649-657 - PubMed
  35. Curr Rheumatol Rep. 2011 Apr;13(2):146-53 - PubMed
  36. J Clin Rheumatol. 2014 Dec;20(8):427-32 - PubMed
  37. BMC Med. 2017 Jul 3;15(1):123 - PubMed
  38. Clin Nucl Med. 2012 Jun;37(6):614-7 - PubMed
  39. Semin Musculoskelet Radiol. 2013 Feb;17(1):74-9 - PubMed
  40. Clin Nucl Med. 2020 Jan;45(1):e29-e31 - PubMed
  41. Eur Radiol. 2018 Dec;28(12):5316-5327 - PubMed
  42. Semin Arthritis Rheum. 2020 Jun;50(3S):S24-S30 - PubMed
  43. AJR Am J Roentgenol. 2016 Jan;206(1):119-28 - PubMed
  44. Semin Arthritis Rheum. 2018 Apr;47(5):703-709 - PubMed
  45. Arthritis Care Res (Hoboken). 2015 Sep;67(9):1304-1315 - PubMed
  46. J Rheumatol. 2009 Jun;36(6):1287-9 - PubMed
  47. Arthritis Care Res (Hoboken). 2012 Oct;64(10):1431-46 - PubMed
  48. Ann Rheum Dis. 2020 Jan;79(1):31-38 - PubMed
  49. Rheum Dis Clin North Am. 2019 Feb;45(1):145-157 - PubMed
  50. Osteoarthritis Cartilage. 2009 Feb;17(2):178-81 - PubMed
  51. BMJ. 2002 Jun 22;324(7352):1488-92 - PubMed
  52. Arthritis. 2013;2013:673401 - PubMed
  53. Semin Arthritis Rheum. 2021 Jun;51(3):644-649 - PubMed
  54. Arthritis Rheum. 2010 Apr;62(4):1060-8 - PubMed
  55. J Clin Rheumatol. 2012 Apr;18(3):138-41 - PubMed
  56. Rheumatology (Oxford). 2019 Mar 1;58(3):410-417 - PubMed
  57. Ann Intern Med. 2016 Apr 5;164(7):464-71 - PubMed
  58. BMC Rheumatol. 2020 May 8;4:22 - PubMed
  59. Joint Bone Spine. 2015 Jan;82(1):42-4 - PubMed
  60. J Clin Rheumatol. 2010 Aug;16(5):209-14 - PubMed
  61. J Orthop Surg Res. 2019 Aug 27;14(1):272 - PubMed
  62. Hong Kong Med J. 2011 Dec;17(6):480-6 - PubMed
  63. N Engl J Med. 2018 Mar 29;378(13):1200-1210 - PubMed
  64. Radiol Clin North Am. 2004 Jan;42(1):169-84 - PubMed
  65. Rheumatology (Oxford). 2014 Jan;53(1):95-103 - PubMed
  66. Radiographics. 2011 Sep-Oct;31(5):1365-75; discussion 1376-7 - PubMed
  67. Arthritis Rheum. 2010 May;62(5):1549-56 - PubMed
  68. Cochrane Database Syst Rev. 2013 Apr 30;(4):CD009920 - PubMed
  69. Ther Adv Musculoskelet Dis. 2019 Apr 16;11:1759720X19844429 - PubMed
  70. Eur Radiol. 2008 Mar;18(3):621-30 - PubMed
  71. Acad Radiol. 2015 Dec;22(12):1497-502 - PubMed
  72. Lancet. 2004 Apr 17;363(9417):1277-81 - PubMed
  73. Biomed Res Int. 2020 May 26;2020:4307385 - PubMed
  74. Arthritis Rheumatol. 2021 Aug;73(8):1533-1542 - PubMed
  75. Ann Rheum Dis. 2007 Jul;66(7):859-64 - PubMed
  76. Clin Pharmacol Ther. 2013 Feb;93(2):153-8 - PubMed
  77. Arthritis Rheumatol. 2020 Jun;72(6):879-895 - PubMed
  78. Radiographics. 2017 May-Jun;37(3):855-870 - PubMed
  79. Arthritis Res Ther. 2019 Jun 21;21(1):150 - PubMed
  80. J Rheumatol. 2004 Dec;31(12):2429-32 - PubMed
  81. Radiology. 2016 Dec;281(3):690-707 - PubMed
  82. AJR Am J Roentgenol. 1980 Apr;134(4):781-7 - PubMed
  83. Ann Emerg Med. 2007 May;49(5):670-7 - PubMed
  84. J Rheumatol. 2012 Sep;39(9):1859-66 - PubMed
  85. Circulation. 2007 Aug 21;116(8):894-900 - PubMed
  86. Semin Arthritis Rheum. 2020 Jun;50(3S):S17-S23 - PubMed
  87. Skeletal Radiol. 2014 Jul;43(7):917-24 - PubMed
  88. J Rheumatol. 2019 Oct;46(10):1345-1349 - PubMed
  89. Arthritis Rheumatol. 2019 Oct;71(10):1739-1746 - PubMed
  90. Nat Rev Rheumatol. 2015 Nov;11(11):649-62 - PubMed
  91. JAMA. 2011 Aug 17;306(7):711-20 - PubMed
  92. Semin Musculoskelet Radiol. 2018 Apr;22(2):225-236 - PubMed
  93. Eur Radiol. 2018 Oct;28(10):4174-4181 - PubMed
  94. Arthritis Rheumatol. 2015 Oct;67(10):2557-68 - PubMed
  95. Arthritis Res Ther. 2010;12(2):R63 - PubMed
  96. Arthritis Care Res (Hoboken). 2021 May;73(5):755-764 - PubMed
  97. Rheumatology (Oxford). 2008 Oct;47(10):1567-70 - PubMed
  98. Ann Rheum Dis. 2013 Sep 1;72(9):1545-8 - PubMed
  99. J Rheumatol. 2015 Nov;42(11):2149-54 - PubMed
  100. Indian J Nucl Med. 2018 Apr-Jun;33(2):158-160 - PubMed
  101. Rheumatology (Oxford). 2019 Dec 1;58(12):2117-2121 - PubMed
  102. Rheumatology (Oxford). 2006 Nov;45(11):1422-31 - PubMed
  103. Joint Bone Spine. 2020 Dec;87(6):647-651 - PubMed
  104. Am J Med. 2014 Apr;127(4):311-8 - PubMed
  105. Skeletal Radiol. 2011 Mar;40(3):309-15 - PubMed
  106. Ann Rheum Dis. 2015 Jun;74(6):1072-7 - PubMed
  107. Ann Rheum Dis. 2002 Jun;61(6):493-8 - PubMed
  108. Clin Exp Rheumatol. 2018 Sep-Oct;36 Suppl 114(5):53-60 - PubMed
  109. Int J Mol Sci. 2021 Jul 09;22(14): - PubMed
  110. Eur J Nucl Med Mol Imaging. 2016 Jul;43(7):1387-8 - PubMed
  111. Clin Nucl Med. 2014 Jun;39(6):579-81 - PubMed
  112. J Med Radiat Sci. 2017 Mar;64(1):41-51 - PubMed
  113. J Rheumatol. 2007 Sep;34(9):1888-93 - PubMed
  114. Lancet. 2016 Oct 22;388(10055):2039-2052 - PubMed
  115. Arthritis Rheum. 2010 Apr;62(4):1069-76 - PubMed
  116. AJR Am J Roentgenol. 2013 Sep;201(3):515-25 - PubMed
  117. Ann Rheum Dis. 2010 Jul;69(7):1305-9 - PubMed
  118. J Belg Soc Radiol. 2020 Jun 03;104(1):27 - PubMed
  119. J Rheumatol. 2015 Dec;42(12):2460-4 - PubMed
  120. Clin Podiatr Med Surg. 2012 Jul;29(3):443-9 - PubMed
  121. J Rheumatol. 2005 Dec;32(12):2368-72 - PubMed
  122. Int J Rheum Dis. 2016 Nov;19(11):1183-1188 - PubMed
  123. BMC Musculoskelet Disord. 2019 Apr 1;20(1):140 - PubMed
  124. Radiographics. 2015 Nov-Dec;35(7):2026-48 - PubMed
  125. Arthritis Rheumatol. 2017 Feb;69(2):429-438 - PubMed
  126. Skeletal Radiol. 2017 Jun;46(6):759-767 - PubMed
  127. Ultrasound Med Biol. 2017 May;43(5):884-892 - PubMed
  128. RMD Open. 2020 Jan;6(1): - PubMed
  129. Clin Exp Rheumatol. 2018 Sep-Oct;36 Suppl 114(5):61-67 - PubMed
  130. Ann Rheum Dis. 2011 Apr;70(4):597-604 - PubMed

Publication Types