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Prevalence of crystal deposits in asymptomatic hyperuricemia according to different scanning definitions: A comparative study. | LitMetric

AI Article Synopsis

  • The study aimed to identify a sonographic protocol for assessing urate crystal deposits in patients with asymptomatic hyperuricemia (AH) and determine how different definitions affect deposition rates and related features.
  • A total of 77 participants were evaluated using ultrasound across 10 locations to identify different types of urate deposits and their associated inflammation and erosions.
  • Results showed a wide range in deposition rates depending on the protocols used, emphasizing the need for a standardized definition to better understand and manage AH.

Article Abstract

Background/aim: The appropriate sonographic protocol for assessing urate crystal deposits in asymptomatic hyperuricemia (AH) is undefined, as well as how the choice would impact on deposit rates and accompanying sonographic, clinical and laboratory features.

Methods: Patients with AH (serum urate ≥7 mg/dL) underwent musculoskeletal ultrasound of 10 locations for OMERACT elementary gout lesions (double contour [DC] signs, tophi, aggregates). Different definitions for AH with deposits were applied, varying according to deposits (any deposits; only DC and/or tophi); gradation (any grade; only grade 2-3 deposits), location (10 locations; 4-joint scheme including knees and 1MTPs; >1 location with deposits), or pre-defined definitions (DC sign in femoral condyles/1MTP and/or tophi in 1MTP). We evaluated crystal deposits rates and compared between other sonographic features, clinical and laboratory variables.

Results: Seventy-seven participants with AH showed a median 1 location (IQR 0-2) with tophi, 1 (IQR 1-2) with aggregates, and 0 locations (IQR 0-1) with DC sign. The deposition rate ranged from 23.4% (in >1 location with grade 2-3 DC or tophi) to 87.0% (in any deposit in all 10 locations). Accompanying inflammation - assessed by a positive power-Doppler (PD) signal - and erosions were found in 19.5% and 28.4% of participants, respectively. Positive PD signal was better discriminated by criteria requiring grade 2-3 or >1 location with lesions. Erosions and the different clinical and laboratory variables were similar among protocols.

Conclusion: Rates of sonographic deposition in AH varied dramatically among studied protocols, while some could discriminate accompanying inflammation, all highlighting the need for a validated, consensus-based definition.

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Source
http://dx.doi.org/10.1016/j.semarthrit.2024.152470DOI Listing

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