Abstract

Objectives A 30-years-old study reported gout to be oligo- or polyarticular in 40% of cases presenting to a rheumatology clinic. The prevalence of gout has increased markedly since and presently gout has become the most prevalent inflammatory joint disease. Furthermore, specific Ultrasound (US) changes in gout have been described in recent years. The aim of this study was to register the clinical characteristics of gout patients diagnosed presently in a rheumatology clinic and the prevalence of gout specific US findings. Methods Data from consecutive new crystal proven gout patient fulfilling the 2015 gout classification criteria at diagnosis were analyzed in an observational study. Results Hundred patients (88 males (62.1 ± 13.1(SD)years), 12 females (74.1 ± 6.9 years)) were included. Disease duration was 8.6 ± 6.9 years; disease pattern was monoarticular/oligoarticular/polyarticular/tophaceous in respectively 18/37/25/20 patients. Podagra ever was found in 74%. Symptoms from upper extremities were present in 47%. Disease severity was positively associated to disease duration and serum-urate. US signs of urate deposition was found in 84% (79/94) of patients Double Contour (DC) sign in 69/94 (73%), Intrasynovial Hyperechoic (ISHE) areas in 64/94(68%). DC sign was associated to serum-urate while ISHE areas was associated to disease severity and disease duration. Conclusion Patients presenting to a rheumatology clinic and diagnosed with crystal proven gout have in most cases long disease duration and display complex clinical characteristics. Specific US findings are very common in gout. It is considered that ISHE areas to determine gout severity whereas DC sign to determine the response to treatment could be used. The study indicates that US is a useful and noninvasive diagnostic tool in gout to determine disease severity and response to treatment.

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