1.Double contour sign in early detection of gout among asymptomatic hyperuricemic Filipino patients: A single center tertiary hospital observational study.
Julie LI-YU ; Dominic DELA CRUZ ; Millicent TAN-ONG ; Leonid ZAMORA ; Richelle Joy BAYSON
Journal of Medicine University of Santo Tomas 2022;6(S1):85-89
Objective:
Double contour sign (DCS) is considered part of the new gout classification. This study aims to determine the agreement of blinded musculoskeletal sonologists in identifying the double contour sign among asymptomatic hyperuricemic patients.
Methods:
Participants with asymptomatic hyperuricemia (n=65) underwent a gray-scale ultrasound assessment of both of their 1st metatarsophalangeal joints (MTPJs) done on 3 positions (dorsal, medial, plantar) in longitudinal view. The static images were read by 2 independent blinded sonologists for presence of double contour sign.
Results:
Among the 130 1st MTPJs, the sonologists were able to positively identify DCS on 48R and 52L, negative in 10R and 10L, with discordant readings in 7R, 3L. The overall kappa agreement was statistically significant at 0.674 (substantial agreement) and 0.842 (almost perfect agreement) on the right and left respectively, (both p<0.001).
Conclusion and Recommendation
There is a high proportion of positive double contour sign seen among persistently asymptomatic hyperuricemic patients. It might be prudent to perform musculoskeletal ultrasound early on to detect monosodium urate crystal deposits in similar patients. A close follow up to monitor clinical gouty arthritis maybe necessary or consider utility of urate lowering drugs in crystal dissolution in prospective studies.
Hyperuricemia
;
Gout
2.Target-Oriented Clinical Skill Enhancement (TOCSE) builds up confidence of fourth-year medical students during first-time patient encounter: An effective bridging tool after online didactic undergraduate classes during the COVID-19 pandemic
Maria Faye Anne S GOMEZ ; Leonid D ZAMORA ; Paul John ABLAZA ; Melvin Remulla MARCIAL ; Leilani B MERCADO-ASIS
Journal of Medicine University of Santo Tomas 2022;6(S1):114-125
Clinical Competence
3.A cross sectional validation study of sonographic findings of the first metatarsophalangeal Joint in gout and asymptomatic hyperuricemia
Dominic Dela Cruz ; Julie Li-Yu ; Richelle Joy Bayson ; Leonid D. Zamora ; Juan Javier T. Lichauco
Philippine Journal of Internal Medicine 2023;61(3):117-121
Objective:
Musculoskeletal ultrasound has gained recognition in early identification of crystal deposits in the joints and soft tissues. This study aims to validate the sonographic features of 1st metatarsophalangeal joints (MTPJs) in gout and asymptomatic hyperuricemia (AH).
Methods
Patients with gout (n=20) and AH (n=16) underwent a gray-scale ultrasound assessment of both 1st MTPJs on 3 positions (dorsal, medial, plantar) in longitudinal view. The static images were read by 2 blinded trained sonologists for the presence of double contour sign (DCS), erosions, and tophi.
Gout
;
Validation Study