【摘 要】
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BACKGROUND AND OBJECTIVEGout is a common arthritis, resulting from the deposition of monosodium urate crystals within the joints. This disorder affects one to two percent of adults in developed countr
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BACKGROUND AND OBJECTIVEGout is a common arthritis, resulting from the deposition of monosodium urate crystals within the joints. This disorder affects one to two percent of adults in developed countries, and may be increasing in prevalence. Crystal deposition has traditionally been identified by using joint aspirants. Gout may also be diagnosed by ultrasound (US), based upon the presence of a"double contour sign". This study evaluated the ability of US to detect a decrease or disappearance of the US features of gout after the initiation of urate lowering therapy.
METHODSThis prospective study included 16 males with gout, averaging 61 years of age. Evaluations were made of the first metatarsophalangeal joints and knees at baseline and after six months of treatment. Medical intervention include either allopurinol, 100 mg per day, or febuxostat, 80 mg per day, both titrated to achieve target serum uric acid levels of less than 360 μmol per liter.
RESULTSFeatures of gout had not disappeared in four patients who did not reach the target blood levels of serum uric acid. Among those who did achieve target levels, there was an excellent correlation with a decrease or disappearance of US features in all joints reviewed.
CONCLUSIONThis study of patients with gout found that the disappearance of urate deposits by ultrasound analysis correlates well with the efficacy of urate lowering therapy drugs.
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