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The clinical course of gout is initially characterized by acute self-limited joint inflammation, but long- standing disease is often associated with chronic inflammation followed by the development of erosive joint damage, which can result in long-term functional impairment. Preventing joint damage is now a major focus of therapeutic intervention in gout. New light has been shed on the mechanisms leading to cartilage and bone damage in patients with this disease. Here, we discuss basic science studies focusing on the cellular immunology of bone and cartilage in gout and the effects of monosodium urate crystals on signaling pathways, cytokine release and the function of osteoclasts, osteoblasts and chondrocytes. We then explore the use of advanced imaging modalities (including MRI, ultrasonography, CT and dual-energy CT) to investigate pathology in gout, as they provide new ways to visualize joint tissues. These modalities vary in their ability to detect the various pathological features of gout and have different clinical applications. Imaging provides information about the inflammatory nature of the joint lesion, position and size of tophaceous deposits, and extent of bone and cartilage damage. Imaging is also increasingly being used to monitor the progression of joint damage and regression of tophi with effective urate-lowering therapy. [ABSTRACT FROM AUTHOR]

Objective: To describe the changes seen in the wrist in rheumatoid arthritis (RA) on magnetic resonance (MR) imaging obtained at 1 year and 6 years.Design: A cohort of patients with RA has been studied prospectively from symptom onset.Patients: MR scans of the dominant wrist in 31 patients obtained at 1 year and 6 years were compared for bone erosions, marrow signal change (oedema), synovial thickness and tenosynovitis.Results: Twenty-two patients had an increase in erosion score in the interval and three patients showed a decrease in erosion score suggesting erosion healing. Fourteen patients had an increase in oedema score in the interval and eight patients had a decrease in oedema score. Synovial thickness increased in 13 patients and decreased in eight. Tenosynovitis increased in 15 patients and decreased in five. Bone erosions developed immediately adjacent to the tenosynovitis in two patients.Conclusions: MR imaging is useful in following the progress of bone erosions, marrow oedema, synovitis and tenosynovitis in RA. [ABSTRACT FROM AUTHOR]

In 2013, much progress has occurred in gout research. Imaging continues to help elucidate aspects of pathophysiology and now suggests that healing of erosions could occur when urate levels are reduced dramatically. New genetic loci associated with hyperuricaemia have been identified and management strategies for prophylaxis of gout flares continue to evolve. [ABSTRACT FROM AUTHOR]

The article discusses advances in gout research in the fields of radiography, genetics and therapeutics that are conducted in 2013. A study by N. Dalbeth explored radiographic changes in patients with tophaceous gout treated with urate-lowering therapy (ULT), while Kottgen et al. used European ancestry data to identify genetic loci associated with serum uric acid (SUA) concentrations. The efficacy of rilonacept for the prevention of gout flare during ULT usage is examined by E. Mitha et al.