Hyperuricemia, resulting in monosodium urate (MSU) crystal deposition in soft tissues and joints
Primary gout: results from abnormalities in purine metabolism or from idiopathic ↓ renal excretion of urate
Secondary gout: results from ↑ serum uric acid levels resulting from associated disorders or precipitating factors
Tophus: chronic granulomatous lesion containing MSU crystals surrounded by inflammatory cells and connective tissue
Tophaceous gout largely extraarticular; intraarticular gout has different manifestations
IMAGING
General Features
Imaging Recommendations
Radiographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Abdellatif W et al: Unravelling the mysteries of gout by multimodality imaging. Semin Arthritis Rheum. 50(3S):S17-23, 2020
Christiansen SN et al: Dual-energy CT in gout patients: do all colour-coded lesions actually represent monosodium urate crystals? Arthritis Res Ther. 22(1):212, 2020
Filippucci E et al: Imaging of crystalline arthropathy in 2020. Best Pract Res Clin Rheumatol. 34(6):101595, 2020
Singh JA et al: Gout epidemiology and comorbidities. Semin Arthritis Rheum. 50(3S):S11-6, 2020
Cho SK et al: The prevalence of hyperuricemia sharply increases from the late menopausal transition stage in middle-aged women. J Clin Med. 8(3), 2019
Davies J et al: Recent developments in advanced imaging in gout. Ther Adv Musculoskelet Dis. 11:1759720X19844429, 2019
De Avila Fernandes E et al: Relevant aspects of imaging in the diagnosis and management of gout. Rev Bras Reumatol Engl Ed. 57(1):64-72, 2017
Pattamapaspong N et al: Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis. Skeletal Radiol. 46(6):759-67, 2017
Mallinson PI et al: Dual-energy CT for the musculoskeletal system. Radiology. 281(3):690-707, 2016
Chowalloor PV et al: Imaging in gout: a review of the recent developments. Ther Adv Musculoskelet Dis. 6(4):131-43, 2014
Mallinson PI et al: Artifacts in dual-energy CT gout protocol: a review of 50 suspected cases with an artifact identification guide. AJR Am J Roentgenol. 203(1):W103-9, 2014
Girish G et al: Advanced imaging in gout. AJR Am J Roentgenol. 201(3):515-25, 2013
Lumezanu E et al: Axial (spinal) gout. Curr Rheumatol Rep. 14(2):161-4, 2012
Desai MA et al: Clinical utility of dual-energy CT for evaluation of tophaceous gout. Radiographics. 31(5):1365-75; discussion 1376-7, 2011
Glazebrook KN et al: Identification of intraarticular and periarticular uric acid crystals with dual-energy CT: initial evaluation. Radiology. 261(2):516-24, 2011
Konatalapalli RM et al: Gout in the axial skeleton. J Rheumatol. 36(3):609-13, 2009
Cammalleri L et al: Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout. Int J Med Sci. 4(2):83-93, 2007
Centers for Disease Control and Prevention (CDC): Projected state-specific increases in self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitations--United States, 2005-2030. MMWR Morb Mortal Wkly Rep. 56(17):423-5, 2007
Choi HK et al: Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 57(1):109-15, 2007
Keith MP et al: Updates in the management of gout. Am J Med. 120(3):221-4, 2007
Pascual E et al: Therapeutic advances in gout. Curr Opin Rheumatol. 19(2):122-7, 2007
Perez-Ruiz F et al: Imaging modalities and monitoring measures of gout. Curr Opin Rheumatol. 19(2):128-33, 2007
Reginato AM et al: Genetics and experimental models of crystal-induced arthritis. Lessons learned from mice and men: is it crystal clear? Curr Opin Rheumatol. 19(2):134-45, 2007
Shah K et al: Does the presence of crystal arthritis rule out septic arthritis? J Emerg Med. 32(1):23-6, 2007
Stamp LK et al: Emerging therapies in the long-term management of hyperuricaemia and gout. Intern Med J. 37(4):258-66, 2007
Thiele RG et al: Diagnosis of gout by ultrasound. Rheumatology (Oxford). 46(7):1116-21, 2007
Wise CM: Crystal-associated arthritis in the elderly. Rheum Dis Clin North Am. 33(1):33-55, 2007
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Diagnostic Checklist
TERMINOLOGY
Synonyms
Gouty arthritis, tophaceous gout
Definitions
Hyperuricemia, resulting in monosodium urate (MSU) crystal deposition in soft tissues and joints
Primary gout: results from abnormalities in purine metabolism or from idiopathic ↓ renal excretion of urate
Secondary gout: results from ↑ serum uric acid levels resulting from associated disorders or precipitating factors
Tophus: chronic granulomatous lesion containing MSU crystals surrounded by inflammatory cells and connective tissue
Tophaceous gout largely extraarticular; intraarticular gout has different manifestations
IMAGING
General Features
Imaging Recommendations
Radiographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Abdellatif W et al: Unravelling the mysteries of gout by multimodality imaging. Semin Arthritis Rheum. 50(3S):S17-23, 2020
Christiansen SN et al: Dual-energy CT in gout patients: do all colour-coded lesions actually represent monosodium urate crystals? Arthritis Res Ther. 22(1):212, 2020
Filippucci E et al: Imaging of crystalline arthropathy in 2020. Best Pract Res Clin Rheumatol. 34(6):101595, 2020
Singh JA et al: Gout epidemiology and comorbidities. Semin Arthritis Rheum. 50(3S):S11-6, 2020
Cho SK et al: The prevalence of hyperuricemia sharply increases from the late menopausal transition stage in middle-aged women. J Clin Med. 8(3), 2019
Davies J et al: Recent developments in advanced imaging in gout. Ther Adv Musculoskelet Dis. 11:1759720X19844429, 2019
De Avila Fernandes E et al: Relevant aspects of imaging in the diagnosis and management of gout. Rev Bras Reumatol Engl Ed. 57(1):64-72, 2017
Pattamapaspong N et al: Value of ultrasonography in the diagnosis of gout in patients presenting with acute arthritis. Skeletal Radiol. 46(6):759-67, 2017
Mallinson PI et al: Dual-energy CT for the musculoskeletal system. Radiology. 281(3):690-707, 2016
Chowalloor PV et al: Imaging in gout: a review of the recent developments. Ther Adv Musculoskelet Dis. 6(4):131-43, 2014
Mallinson PI et al: Artifacts in dual-energy CT gout protocol: a review of 50 suspected cases with an artifact identification guide. AJR Am J Roentgenol. 203(1):W103-9, 2014
Girish G et al: Advanced imaging in gout. AJR Am J Roentgenol. 201(3):515-25, 2013
Lumezanu E et al: Axial (spinal) gout. Curr Rheumatol Rep. 14(2):161-4, 2012
Desai MA et al: Clinical utility of dual-energy CT for evaluation of tophaceous gout. Radiographics. 31(5):1365-75; discussion 1376-7, 2011
Glazebrook KN et al: Identification of intraarticular and periarticular uric acid crystals with dual-energy CT: initial evaluation. Radiology. 261(2):516-24, 2011
Konatalapalli RM et al: Gout in the axial skeleton. J Rheumatol. 36(3):609-13, 2009
Cammalleri L et al: Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout. Int J Med Sci. 4(2):83-93, 2007
Centers for Disease Control and Prevention (CDC): Projected state-specific increases in self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitations--United States, 2005-2030. MMWR Morb Mortal Wkly Rep. 56(17):423-5, 2007
Choi HK et al: Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 57(1):109-15, 2007
Keith MP et al: Updates in the management of gout. Am J Med. 120(3):221-4, 2007
Pascual E et al: Therapeutic advances in gout. Curr Opin Rheumatol. 19(2):122-7, 2007
Perez-Ruiz F et al: Imaging modalities and monitoring measures of gout. Curr Opin Rheumatol. 19(2):128-33, 2007
Reginato AM et al: Genetics and experimental models of crystal-induced arthritis. Lessons learned from mice and men: is it crystal clear? Curr Opin Rheumatol. 19(2):134-45, 2007
Shah K et al: Does the presence of crystal arthritis rule out septic arthritis? J Emerg Med. 32(1):23-6, 2007
Stamp LK et al: Emerging therapies in the long-term management of hyperuricaemia and gout. Intern Med J. 37(4):258-66, 2007
Thiele RG et al: Diagnosis of gout by ultrasound. Rheumatology (Oxford). 46(7):1116-21, 2007
Wise CM: Crystal-associated arthritis in the elderly. Rheum Dis Clin North Am. 33(1):33-55, 2007
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