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In patients with acute mono/oligoarthritis, a targeted ultrasound scanning protocol shows great accuracy for the diagnosis of gout and CPPD.

Authors :
Cipolletta, Edoardo
Filippucci, Emilio
Abhishek, Abhishek
Battista, Jacopo Di
Smerilli, Gianluca
Carlo, Marco Di
Silveri, Ferdinando
Angelis, Rossella De
Salaffi, Fausto
Grassi, Walter
Matteo, Andrea Di
Source :
Rheumatology. Apr2023, Vol. 62 Issue 4, p1493-1500. 8p.
Publication Year :
2023

Abstract

Objectives To determine an US scanning protocol with the best accuracy for the diagnosis of gout and CPPD in patients with acute mono/oligo-arthritis of unknown origin. Methods Patients with acute mono/oligo-arthritis in whom a joint aspiration at the most clinically involved joint (target joint) was requested were consecutively enrolled. US was performed in each patient before the arthrocentesis. The accuracy of different US findings and scanning protocols for the diagnosis of gout and CPPD was calculated. Results A total of 161 subjects were included (32 gout patients, 30 CPPD patients and 99 disease-controls). US findings had a high specificity for gout (0.92–0.96) and CPPD (0.90–0.97), while the sensitivity ranged from 0.73 to 0.85 in gout (double contour sign and tophi, respectively) and from 0.60 to 0.90 in CPPD (hyaline and fibrocartilage deposits, respectively). The US assessment of two joints bilaterally (gout: knees, MTP1 joints; CPPD: knees, wrists) plus the target joint had an excellent diagnostic sensitivity (gout: 0.91, CPPD: 0.93) and specificity (gout: 0.91, CPPD: 0.89). This targeted US scanning protocol yielded to higher diagnostic accuracy compared with the US evaluation of the target joint [gout area under the curve (AUC) 0.91 vs 0.84, P  = 0.03; CPPD AUC 0.93 vs 0.84, P  = 0.04] unless the target joint was the knee or the MTP1 joint in gout and the knee or the wrist in CPPD. Conclusions A targeted US scanning protocol of two joints bilaterally plus the target joint showed an excellent accuracy (>90%) for the diagnosis of crystal arthritis in patients with acute mono/oligoarthritis.   A video abstract is available for this article and can be viewed at https://doi.org/10.1093/rheumatology/keac479. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14620324
Volume :
62
Issue :
4
Database :
Academic Search Index
Journal :
Rheumatology
Publication Type :
Academic Journal
Accession number :
162940891
Full Text :
https://doi.org/10.1093/rheumatology/keac479