The value of high frequency ultrasound screening for asymptomatic hyperuricemia in patients with joint diseases / 中华风湿病学杂志

ABSTRACT

Objective To explore the value of high frequency color Doppler ultrasound for the early diagnosis of asymptomatic hyperuricemia in patients with joint disease.Methods Blood pressure,uric acid,total cholesterol,triglyceride and blood glucose were measured in 44 asymptomatic individual with hyperuricemia (the AH group) and 52 healthy persons (the control group),and the joints of the first metatarsalphalan geal,ankles,knees,wrists,elbows and the first metacarpophalangeal joints in the two groups were examined by high frequency and color Doppler ultrasound.T test,Chi-square test,and Fisher exact test were used for statistical analysis.Results ① The incidence rate of hypertension,diabetes and hyperlipidemia in the AH group [43.2％(19/44),22.7％(10/44),13.6％(6/44)] was significantly higher than the control group (x2=27.995,13.129,7.564;P＜0.01);② Double contour sign were found in the first metatarsal-phalangeal,ankles,knees and elbows of the AH group,in contrast to none in the control group (P＜0.05).The incidence of synovial thickening in the first metatarsal-phalangeal [1.5％(8/528)],ankles of the AH group [1.3％(7/528)]was significantly higher than that of the control group [0(0/624),0.2％(1/624)] (x2=9.521,P＜0.01;x2=5.634,P＜0.05).Similar results were found in the two groups in bone erosion in knees [1.7％(9/528) vs 0.3％(2/624)],in knees effusion [6.0％(32/528) vs 0.96％(6/624)] (x2=5.793,P＜0.05;x2=23.623,P＜0.01).The tophi was found in the fight first metatarsal-phalangeal,bilateral knees and the left first metacarpophalangeal 4 joints in 528 joints of the AH group,in contrast to none in the control group (P＜0.05).The difference in hyperechoic spots was no statistically significant between the two groups (P＞0.05).Conclusion Hyperuricemia is related to hypertension,diabetes and high blood lipids.There are some similar specific sonographic findings of gouty arthritis in the asymptomatic individuals with hyperuricemia.Therefore,these findings support that frequent ultrasound examination is a useful tool for the early diagnosis of asymptomatic hyperuricemia with joint disease,especially the screening of the first meta-tarso-phalangeal joint,ankle joint and knee joint.