Department of Radiology, Department of Emergency and Trauma Radiology, University of British Columbia/ Vancouver General Hospital, 899W 12th Ave, Vancouver, BC V5Z 1M9, Canada.
Faculty of Science, University of British Columbia, Vancouver, BC, Canada.
Semin Arthritis Rheum. 2020 Jun;50(3S):S17-S23. doi: 10.1016/j.semarthrit.2020.04.009.
Gout is a common inflammatory arthritis that manifests as an aggregate of variably symptomatic monosodium urate crystals (MSU) in the joints and surrounding tissues in addition to multisystem involvement such as genitourinary and cardiovascular systems. In recent decades, there has been a documented increase in the prevalence and incidence of gout. Risk factors for gout include obesity, dietary influences, hypertension, renal impairment, and diuretic use. A prompt diagnosis followed by uric acid lowering treatment prior to the onset of bone destruction is the goal in any suspected case of gout. Advanced imaging modalities, such as dual energy computed tomography (DECT) and ultrasonography (US), employed for the diagnosis of gout are each accompanied by advantages and disadvantages. Conventional radiography (CR), although useful in visualizing joint erosions and mineralization, is limited in its ability to diagnose gout flare. Although synovial fluid aspiration remains the gold standard for MSU crystal visualization, less-invasive imaging modalities are preferred to avoid potential complications. DECT and US in particular are useful in the diagnosis of gout. In this review, we will discuss the current state and role of imaging in the detection of gout.
痛风是一种常见的炎性关节炎，除了累及泌尿生殖和心血管系统等多系统外，还表现为关节及其周围组织中不同症状的单钠尿酸盐晶体（MSU）的聚集。近几十年来，痛风的患病率和发病率都有记录性的增加。痛风的危险因素包括肥胖、饮食影响、高血压、肾功能损害和利尿剂使用。在任何疑似痛风病例中，及时诊断并在骨破坏发生前进行尿酸降低治疗是目标。用于痛风诊断的高级成像方式，如双能 CT（DECT）和超声（US），各自都有优点和缺点。传统射线照相（CR）虽然可用于观察关节侵蚀和矿化，但在诊断痛风发作方面能力有限。虽然关节液抽吸仍然是 MSU 晶体可视化的金标准，但为了避免潜在的并发症，更具侵入性的成像方式更受青睐。DECT 和 US 特别有助于痛风的诊断。在这篇综述中，我们将讨论成像在痛风检测中的现状和作用。
