Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Asymptomatic Hyperuricemia: Ultrasonographic Findings.

Solano3,  Carla, Rodriguez-Henriquez4,  Pedro José, Hofmann4,  Fritz, Bernal4,  Araceli, Marin-Arriaga4,  Norma, Lopez-Reyes4,  Alberto Gabriel, Guirado1,  Luis

Instituto Nacional de Cardiología, Mexico
Instituto Nacional de Rehab, Mexico City, Mexico
Instituto Nacional de Rehabilitación, El Salvador
Instituto Nacional de Rehabilitación, Mexico
Universitá Politecnicá delle Marche Ospedale "A Murri", Italy

Background:

Musculoskeletal ultrasound (US) is a low-cost, widely accessible, non-invasive technique, which allows a multiplanar, real-time evaluation of joints without the use of ionizing radiation. Its use has recently been expanded to the evaluation of inflammatory arthritides, including gout. Ultrasonographic characteristics of gout are already well defined; however, the findings in asymptomatic patients have not been thoroughly described. US have shown to be superior in detecting changes in gouty arthritis than other imaging techniques.

Objective:

To characterize the morphostructural abnormalities detected by US associated with the deposition of crystals in articular and extra-articular tissues of patients with asymptomatic hyperuricemia.

Methods:

Men and women older than 18-years with asymptomatic hyperuricemia (serum uric acid >=7.0 mg/dL and no joint complaints), without urate-lowering therapy; and normouricemic subjects without articular symptoms (control group) were recruited after informed consent was obtained. US scans of the femoral cartilage and tendons in the knee, tendons at the ankle, Achilles tendon and first metatarsophalangeal (1st MTP) joint were obtained. OMERACT definitions for US pathology were applied; tendinopathy: was defined as a loss of the fibrilar pattern, intratendinous tophi and/or calcifications.

Results:

Demographics: 97 subjects were enrolled; 45 hyperuricemic and 52 normouricemic control subjects with a median age of 56 and 47.3 years. The average uric acid level in the hyperuricemic group was 8.17mg/dL (±0.95), see Table 1.

Table 1.

VariableHyperuricemia (n=45)Normouricemia (n=52)P
Age, years56 ± 17.247.3 ± 10.90.003*
Male30350.9**
Uric Acid, mg/dL8.17 ± 0.955.47 ± 0.90<0.0001*
* Unpaired t test
** Chi-square test

In the hyperuricemic group tendinopathy was found in the posterior tibial tendon p < 0.05, as well as the presence of double contour sign in the 1st MTP joint p <0.0001.

Table 2.

VariableHyperuricemiaNormouricemiaP
Osteophytes128Ns
Erosions76Ns
Power Doppler00Ns
Synovitis3225Ns
Double contour sign241<0.0001
* All analyses were performed by chi-square tests.

Conclusion:

Asymptomatic hyperuricemic patients show US morphostructural changes similar to those with established gout. Results confirm the notion that urate crystals are present in articular tissues before gout is clinically evident and may give further support for the use of urate-lowering therapy in asymptomatic hyperuricemic patients.

To cite this abstract, please use the following information:
Solano, Carla, Rodriguez-Henriquez, Pedro José, Hofmann, Fritz, Bernal, Araceli, Marin-Arriaga, Norma, Lopez-Reyes, Alberto Gabriel, et al; Asymptomatic Hyperuricemia: Ultrasonographic Findings. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1614
DOI: 10.1002/art.29380

Abstract Supplement

Meeting Menu

2010 ACR/ARHP