Wang Jing, Shao Qin
Department of Rheumatology, Chongqing City Hospital of Traditional Chinese Medicine, No. 6, Pan Xi Qi Zhi Road, 400021, Jiang Bei District Chongqing, China.
Z Rheumatol. 2024 Dec;83(Suppl 3):321-328. doi: 10.1007/s00393-024-01587-8. Epub 2024 Nov 25.
An observational study was conducted to determine whether semiquantitative scoring of ultrasound signs of gout predicted flare over 12 months.
Gout patients were enrolled consecutively in this 12-month prospective observational single-center study. Ultrasound evaluation and clinical assessment were performed at baseline. All patients were examined bilaterally evaluating 14 joints (knee, ankle, metatarsophalangeal joints 1-5) and 10 tendons (posterior tibial, quadriceps, peroneus longus and brevis scored as one, patellar, and Achilles tendons). The following ultrasound features were examined and semiquantitative scoring was performed: DC sign, aggregates, tophi, bone erosion, synovial hypertrophy, PD activity, and tenosynovitis. Patients were divided into two groups, one with flares during the follow-up period and the other without flares.
A total of 119 participants completed the study; 61 (51.3%) participants experienced at least one flare over 12 months, with a median of 2.0 flares. The ultrasound findings indicative of DC sign, aggregate, tophi, bone erosion, and PD activity at baseline were significantly correlated with the development of gout flares over 12 months. Logistic regression analysis suggested that DC sign score (OR: 2.41, 95% CI: 0.92-4.37; P = 0.02), tophi score (OR: 1.87, 95% CI: 0.65-2.28; P = 0.04), and PD activity score (OR: 1.93, 95% CI: 0.58-3.26; P = 0.03) were independent predictors of flare. ROC curve analysis to assess ultrasound semiquantitative scoring has good sensitivity and specificity for the prediction of gout flares.
Ultrasound semiquantitative scoring can predict the risk of flare, and ultrasound findings indicative of DC sign, tophi, and PD activity are independent predictors of gout flares over 12 months.
进行一项观察性研究，以确定痛风超声征象的半定量评分是否能预测12个月内的痛风发作。
在这项为期12个月的前瞻性观察性单中心研究中，连续纳入痛风患者。在基线时进行超声评估和临床评估。对所有患者的双侧14个关节（膝关节、踝关节、第1 - 5跖趾关节）和10条肌腱（胫后肌腱、股四头肌肌腱、腓骨长短肌肌腱视为一条、髌腱和跟腱）进行检查。检查以下超声特征并进行半定量评分：双轨征（DC征）、尿酸盐结晶聚集、痛风石、骨质侵蚀、滑膜肥厚、血流动力学活性（PD活性）和腱鞘炎。患者分为两组，一组在随访期间有痛风发作，另一组无发作。
共有119名参与者完成了研究；61名（51.3%）参与者在12个月内经历了至少一次痛风发作，中位数为2.0次发作。基线时提示双轨征、尿酸盐结晶聚集、痛风石、骨质侵蚀和血流动力学活性的超声表现与12个月内痛风发作的发生显著相关。逻辑回归分析表明，双轨征评分（比值比：2.41，95%置信区间：0.92 - 4.37；P = 0.02）、痛风石评分（比值比：1.87，95%置信区间：0.65 - 2.28；P = 0.04）和血流动力学活性评分（比值比：1.93，95%置信区间：0.58 - 3.26；P = 0.03）是痛风发作的独立预测因素。评估超声半定量评分的ROC曲线分析对痛风发作的预测具有良好的敏感性和特异性。
超声半定量评分可以预测痛风发作风险，提示双轨征、痛风石和血流动力学活性的超声表现是12个月内痛风发作的独立预测因素。
