Diagnostic efficacy of joint ultrasonography, dual-energy computed tomography and minimally invasive arthroscopy on knee gouty arthritis, a comparative study
| Autor: | Ting Xu, Guangfeng Zhang, Haobo Lin, Yuesheng Xie, Fangping Xu, Xiao Zhang, Riqiang Luo, Lin Yang, Ling Li |
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| Rok vydání: | 2021 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Knee Joint Arthritis Sensitivity and Specificity Arthroscopy 03 medical and health sciences 0302 clinical medicine Synovial Fluid Odds Ratio medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies 030212 general & internal medicine Gouty arthritis Prospective cohort study Ultrasonography 030203 arthritis & rheumatology Full Paper medicine.diagnostic_test Arthritis Gouty business.industry Dual-Energy Computed Tomography General Medicine Middle Aged medicine.disease Uric Acid Gout Female Radiology Tomography Tomography X-Ray Computed business |
| Zdroj: | Br J Radiol |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/bjr.20200493 |
| Popis: | Objective: This study aimed to investigate the diagnostic performance of minimally invasive arthroscopy for knee gout when comparing with joint ultrasonography and dual-energy computed tomography (DECT). Methods: From January 2016 to December 2018, 121 inpatients with knee joint swelling and pain were prospectively enrolled, including 63 gout patients and 58 non-gout patients. All patients underwent pre-operative ultrasonography and DECT to evaluate knee joint monosodium urate (MSU) deposits, followed by minimally invasive arthroscopy. The gold-standard for gout diagnosis was defined as the detection of MSU crystals in the synovial fluid under polarizing microscopic or pathological analysis. Results: The diagnostic results of ultrasonic double contour sign, hyperechogenic foci, MSU deposition (detected by DECT), MSU deposition (detected by arthroscopy) and MSU deposition in cartilage (detected by arthroscopy) were significantly associated with that of the gold-standard. Except for hyperechogenic foci, the other four indexes had high sensitivity and specificity (approximately or over 80%) and a large odds ratio (OR) (14.73 to 36.56), indicating good diagnostic performance. Detection of MSU deposition in cartilage by arthroscopy had a good diagnostic agreement with the ultrasonic double contour sign (κ = 0.711, p < 0.001). Conclusion: Joint ultrasonography, DECT, and minimally invasive arthroscopy had high sensitivity and specificity for the diagnosis of knee gouty arthritis. Minimally invasive arthroscopy was superior to joint ultrasonography and DECT, which can be a useful supplement for the diagnosis of gout. Advances in knowledge: This is the first study comparing the diagnostic performance for knee gout among the joint ultrasonography, DECT, and minimally invasive arthroscopy. |
| Databáze: | OpenAIRE |
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