Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging

Jennifer S Weaver; Ernest R Vina; Peter L Munk; Andrea S Klauser; Jamie M Elifritz; Mihra S Taljanovic

doi:10.3390/jcm11010166

Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging

J Clin Med. 2021 Dec 29;11(1):166. doi: 10.3390/jcm11010166.

Authors

Jennifer S Weaver¹, Ernest R Vina², Peter L Munk^{3

4}, Andrea S Klauser⁵, Jamie M Elifritz^{6

7}, Mihra S Taljanovic^{1

8}

Affiliations

¹ Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA.
² Department of Medicine, University of Arizona Arthritis Center, Tucson, AZ 85724, USA.
³ Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
⁴ Department of Radiology, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada.
⁵ Radiology Department, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
⁶ Departments of Radiology and Pathology, University of New Mexico, Albuquerque, NM 87131, USA.
⁷ New Mexico Office of the Medical Investigator, Albuquerque, NM 87131, USA.
⁸ Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85721, USA.

Abstract

Gout, a crystalline arthropathy caused by the deposition of monosodium urate crystals in the articular and periarticular soft tissues, is a frequent cause of painful arthropathy. Imaging has an important role in the initial evaluation as well as the treatment and follow up of gouty arthropathy. The imaging findings of gouty arthropathy on radiography, ultrasonography, computed tomography, dual energy computed tomography, and magnetic resonance imaging are described to include findings of the early, acute and chronic phases of gout. These findings include early monosodium urate deposits, osseous erosions, and tophi, which may involve periarticular tissues, tendons, and bursae. Treatment of gout includes non-steroidal anti-inflammatories, colchicine, glucocorticoids, interleukin-1 inhibitors, xanthine oxidase inhibitors, uricosuric drugs, and recombinant uricase. Imaging is critical in monitoring response to therapy; clinical management can be modulated based on imaging findings. This review article describes the current standard of care in imaging and treatment of gouty arthropathy.

Keywords: CT; crystalline arthropathy; dual energy CT; gout; imaging; magnetic resonance imaging; monosodium urate crystals; radiography; sonography; treatment.

Publication types

Review