ABSTRACT
Objective@#Musculoskeletal ultrasound has gained recognition in early identification of crystal deposits in the joints and soft tissues. This study aims to validate the sonographic features of 1st metatarsophalangeal joints (MTPJs) in gout and asymptomatic hyperuricemia (AH).@*Methods@#Patients with gout (n=20) and AH (n=16) underwent a gray-scale ultrasound assessment of both 1st MTPJs on 3 positions (dorsal, medial, plantar) in longitudinal view. The static images were read by 2 blinded trained sonologists for the presence of double contour sign (DCS), erosions, and tophi.
Subject(s)
Gout , Validation StudyABSTRACT
Resumen La ingesta accidental de cuerpos extraños constituye una emergencia en los servicios de atención pediátrica y el grupo más frecuentemente afectado se encuentra en los pacientes entre los 6 meses y los 3 años. Asimismo, la ingesta de pilas de botón es un factor de riesgo importante para el desarrollo de complicaciones tempranas severas como la perforación esofágica y mediastinitis, y a largo plazo, la aparición de estenosis. Por este motivo, su identificación temprana y la extracción constituyen las estrategias más importantes de manejo. Se ha descrito como característico el hallazgo del doble contorno en la radiografía frontal cérvico-toracoabdominal en estos pacientes. Sin embargo, se ha reportado el mismo signo radiológico en cuerpos extraños diferentes. En el presente artículo se presentan dos casos con estas características.
Abstract Accidental ingestion of foreign bodies constitutes an emergency for pediatric care services especially since the group most frequently affected consists of children between 6 months and 3 years of age. Ingestion of button cell batteries has high risks for severe early complications such as esophageal perforations and mediastinitis, as well as the long term risk of stenosis. Early identification and extraction are the most important management strategies. A double contour on a frontal cervical, thoracic, or abdominal x-ray is characteristic, but this same radiological sign has been reported for other foreign bodies. We present two cases with these characteristics.
Subject(s)
Humans , Male , Infant , Child, Preschool , Radiography , Gastrointestinal Tract , Batteries , Button-Cell Batteries , Foreign Bodies , Patients , Risk Factors , EmergenciesABSTRACT
OBJECTIVE: To explore related factors of changes in gouty patients by ultrasonography after initiation of uric acid lowering therapy. METHODS: There were 72 gout patients enrolled who admitted to First hospital of Peking University from December 2012 to June 2017. All the patients had clinical and ultrasound examination at both knees, ankles and feet joints at the baseline. Regular uric acid lowering therapy started for one year. The endpoint was the last time who repeat the ultrasound examination during the follow up.According with uric acid level and its measuring time, the area under the curve was calculated to reflect the uric acid burden. RESULTS: In the 216 jonts of 72 patients, double contour sign were detectable in 112/216(51.85%), tophi were detectable in71/216(32.87%).Among MTP Joints, DCS was detected in 32/144(22.22%), and tophi in 47/144(32.64%). Among Knees joints, DCS was detected in 33/144(22.92%), tophi in 4/144(2.78%). Among ankle joints, DCS was detected in 47/144(32.64%), tophi in 20/144(13.89%).DCS disappearance occurred in 38/55(69.09%) joints positive for DCS at baselineTime-to-disappearance was 148 days(985～133 days). Tophi disappeared completely in 18/45 joints(40%). Time-to-disappearance was 382.5 days(686～397.25 days). There was no significant difference in age, BMI, duration of disease and complications between DCS persisted group and DCS disappearance group.SUA in the DCS disappeared group at baseline, second, third, fourth and ninth months of follow-up. was significantly lower than that of the non-disappeared group. SUA load in the DCS group was significantly lower than the non-disappeared group. Post hoc tests showed that SUA levels fell significantly from baseline through fourth month of follow-up in DCS disappearance group, and SUA of the sixth months was the lowest. CONCLUSION: To screen for specific features of gout such as DCS or tophi by US at initiation of ULT and during follow-up is a useful, and effective way to detect the lowering and often disappearance of burden of urate load in gouty joints.