1.Multiple tartaric of hand and foot: a case report.
Xiao-gang LIU ; Yi-lin LIU ; Zhi-jie XIE
China Journal of Orthopaedics and Traumatology 2013;26(12):1031-1032
Gout
;
diagnostic imaging
;
surgery
;
Humans
;
Radiography
;
Tartrates
;
analysis
;
Young Adult
2.Diagnostic values of urinary citrate for kidney stones in patients with primary gout.
Yu WANG ; Hui Min ZHANG ; Xue Rong DENG ; Wei Wei LIU ; Lu CHEN ; Ning ZHAO ; Xiao Hui ZHANG ; Zhi Bo SONG ; Yan GENG ; Lan Lan JI ; Yu WANG ; Zhuo Li ZHANG
Journal of Peking University(Health Sciences) 2022;54(6):1134-1140
OBJECTIVE:
To evaluate the relationship between 24 h urinary ion content and kidney stones, and to explore the diagnostic values of kidney stone in primary gout patients.
METHODS:
Patients diagnosed with primary gout had ultrasound scanning of both feet and kidneys in Peking University First Hospital from Jan. 2020 to May 2021. Their clinical characteristics were compared between the positive and negative kidney stone groups, and the relationship between kidney stone and urinary ion composition were analyzed. Risk factors of kidney stone were analyzed. The explored diagnostic values were evaluated for urinary oxalate and citrate according with uric acid kidney stones by dual-energy computed tomography (DECT).
RESULTS:
Among the 100 gouty patients, 80 patients had uric acid crystal deposition in lower joints of extremity by ultrasonography, 61 patients had kidney stone, and 34 had kidney uric acid stones by DECT. All the multiple kidney stones were proved as uric acid kidney stones by DECT. Compared with patients without kidney stone group proved by ultrasonography, patients with kidney stone had longer gouty duration [(48.7±26.6) months vs. (84.0±30.6) months, P=0.01], higher 24 h urinary oxalate [(20.1±9.6) mg vs. (28.6±20.7) mg, P=0.001] and lower 24 h urinary citrate [(506.3±315.4) mg vs. (355.7±219.6) mg, P=0.001]. Compared with the patients without kidney stone by DECT, the patients with uric acid kidney stone also had longer disease duration [(49.1±28.4) months vs. (108.3±72.2) months, P=0.001], higher 24 h urinary oxalate [(23.6±16.9) mg vs. (28.5±18.8) mg, P < 0.05], lower 24 h urinary citrate [(556.0±316.3) mg vs. (391.7±261.2) mg, P < 0.05], higher serum uric acid [(466.2±134.5) μmol/L vs. (517.2±18.1) μmol/L, P < 0.05] and higher 24 h urinary uric acid [(1 518.1±893.4) mg vs. (1 684.2±812.1) mg, P < 0.05]. Logistic regression analysis showed long gout disease duration (OR=1.229, 95%CI: 1.062-1.522, P < 0.05), high serum uric acid level (OR=1.137, 95%CI: 1.001-1.213, P=0.01), low 24 h urinary citrate (OR=0.821, 95%CI: 0.659-0.952, P=0.01) were all risk factors of kidney stones by ultrasonography. Also, long gout disease duration (OR=1.201, 95%CI: 1.101-1.437, P=0.005), high serum creatine uric level (OR=1.145, 95%CI: 1.001-1.182, P=0.04), low 24 h urinary citrate (OR=0.837, 95%CI: 0.739-0.931, P=0.02) were all risk factors of kidney uric acid stones by DECT.
CONCLUSION
Long disease duration and low 24 h urinary citrate were risk factors for kidney stones.
Humans
;
Urinary Calculi
;
Uric Acid/analysis*
;
Citric Acid
;
Kidney Calculi/diagnostic imaging*
;
Gout/diagnostic imaging*
;
Citrates
;
Oxalates
4.Risk factors and diagnostic value for ultrasound-detected tendon monosodium urate crystal deposition in patients with gout.
Yu WANG ; Xue Rong DENG ; Lan Lan JI ; Xiao Hui ZHANG ; Yan GENG ; Zhuo Li ZHANG
Journal of Peking University(Health Sciences) 2020;53(1):143-149
OBJECTIVE:
To evaluate frequency and patterns, risk factors of MSU (monosodium urate) crystal deposition at lower extremity tendon by ultrasonography in gout patients, and to explore diagnostic value by ultrasonography.
METHODS:
Patients diagnosed with gout and age matched healthy controls had ultrasound scanning of both feet and knees including joints and tendons (achilles, quadriceps, and patellar tendon). Readers who scored the ultrasound scans for MSU crystal deposition were blinded to the patients' clinical diagnoses. Clinical characteristics were compared between positive and negative crystal deposition groups by US, and risk factors of MSU deposition in tendons were analyzed. Diagnostic values of MSU deposition were evaluated by ultrasonography according with positive MSU crystal in synovial fluid or tophi by polarized microscopy.
RESULTS:
Eighty patients and eighty healthy controls were included. Thity-three patients (47.5%) had tophi by physical examination. The achilles tendon was the most commonly involved tendon site 41(51.2%), followed by the quadriceps tendons 22(27.5%), and patella tendon 10(12.5%). There were no MSU deposition in healthy control group at tendon by ultrasonography. Compared with negative MSU deposition at tendon site by ultrasonography, tendon MSU positive patients had longer mean gout duration [(87.3±40.9) months vs. (7.7±2.6) months, P=0.001];higher frequency of gout flare [2(1, 2) /year vs. 1(1, 1) /year, P=0.001]; higher BMI [(26.3±2.5) kg/m2vs. (23.3±2.1) kg/m2, P=0.05]. Also, the mean serum uric acid and creatinine levels were higher in tendon MSU positive group [(584.6±87.6) μmol/L vs. (460.4±96.7) μmol/L, P=0.001] and [(90.9±33.3) μmol/L vs. (70.6±40.2) μmol/L, P=0.02] separately. Logistic regression analysis showed gout duration and flare frequency were independent risk factors for MSU deposition at tendon by ultrasonography (P < 0.01). Joint or tophi aspirations were performed in all the eighty gout patients, and positive MSU crystals in synovial fluid analysis by polarized microscopy were defined as the golden standard of gout diagnosis. When compared with the golden standard, the sensitivity and specificity were 94.0% and 78.0% separately for MSU deposition at tendon by ultrasonography.
CONCLUSION
Tendon involvement at the lower extremity tendons in gout is very common. Long gout disease duration and high frequency of gout flare are both independent risk factors of tendon MSU deposition by ultrasonography. Ultrasonography had good sensitivity and specificity for detecting tendinous tophi and aggregates.
Gout/diagnostic imaging*
;
Humans
;
Risk Factors
;
Symptom Flare Up
;
Ultrasonography
;
Uric Acid
5.Clinical characteristics of crystal deposits in joints and tendons in patients with gout.
Zhe PENG ; Ya Min DING ; Lin PEI ; Hai Hong YAO ; Xue Wu ZHANG ; Su Mei TANG
Journal of Peking University(Health Sciences) 2021;53(6):1067-1071
OBJECTIVE:
To explore the abnormal manifestations and clinical features of patients with gout according to the location of crystal deposits: in articulars or in tendons.
METHODS:
A total of 105 patients with gout who were continuously treated in the Department of Rheumatology and Immunology of Peking University People's Hospital from June 2019 to December 2019 were selected and their knees, ankles, toes and painful joints and tendons were examined by high-frequency ultrasound. Then we grouped them according to the presence or absence of sodium urate crystals and the location of the crystals, collected their clinical data, and analyzed the clinical characteristics.
RESULTS:
Among the 105 patients, 25 patients had no crystal deposits in the joints or tendons (as the non-crystal group), 43 patients had intra-articular crystals (as the joint group), and 37 patients had intra-tendon crystals with or without intra-articular crystals (as the tendon group). Among them, the most involved part of sodium urate crystals deposited in the joints was the metatarsophalangeal joint (29 cases, 67.4%), followed by knee joints (10 cases, 23.2%), ankle joints (9 cases, 20.9%). The most involved part of sodium urate crystals deposited in the tendon was the quadriceps tendon (16 cases, 43.2%), followed by the Achilles tendon (13 cases, 35.1%), the patellar tendon (12 cases, 32.4%), and the three heads of brachii tendons (5 cases, 13.5%). The three groups were compared using multi-sample analysis of variance/multi-sample rank sum test. Age, age of first increase in uric acid (UA), serum glucose (Glu) level and C reactive protein (CRP) were all significantly different. After multiple comparisons, compared with the non-crystal group, age, the age of first increase in uric acid, and CRP were significantly higher in the tendon group. There was no significant difference between the non-crystal group and the joint group. There was no significant difference between the tendon group and the joint group.
CONCLUSION
In patients with gout, it is common for ultrasound to find crystals deposited in joints or tendons. The most commonly affected parts include the metatarsophalangeal joint, knee joint, ankle joint, quadriceps tendon, Achilles tendon, patellar tendon, and triceps tendon. There were significant differences among the three groups in age, age of first increase in uric acid, CRP and blood glucose, and the proportion of urinary calculi in patients with crystal deposits was significantly higher than those without crystal deposits.
Achilles Tendon
;
Gout
;
Humans
;
Knee Joint
;
Metatarsophalangeal Joint/diagnostic imaging*
;
Uric Acid
6.Periarticular FDG Uptake on PET/CT in malignant melanoma-metastatic or misleading?
Gerald J S TAN ; Sze Ting LEE ; Salvatore U BERLANGIERI ; Andrew M SCOTT
Annals of the Academy of Medicine, Singapore 2013;42(3):159-160
Aged
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Diagnosis, Differential
;
Fluorodeoxyglucose F18
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Gout
;
diagnostic imaging
;
Humans
;
Joints
;
diagnostic imaging
;
Male
;
Melanoma
;
diagnostic imaging
;
secondary
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Multimodal Imaging
;
Positron-Emission Tomography
;
Radiopharmaceuticals
;
Skin Neoplasms
;
diagnostic imaging
;
secondary
;
Tomography, X-Ray Computed
7.Primary gout in Shantou: a clinical and epidemiological study.
Qingyu ZENG ; Qingwen WANG ; Ren CHEN ; Zhengyu XIAO ; Shaobi HUANG ; Jingcai XU
Chinese Medical Journal 2003;116(1):66-69
OBJECTIVETo evaluate the prevalence of primary gout in the Shantou area, China, and to understand its clinical features.
METHODSSamples from three surveys of the Chenghai across ten years were studied. Clinical, laboratory and radiology data of 419 cases of primary gout were collected and analyzed.
RESULTSPrevalence of primary gout in the three surveys were 0.17%, 0.15% and 0.26%, respectively. Among the clinical patients, the ratio of male to female was 21:1; the average age of onset of women was significantly higher than that of men. The number of cases in the last ten years has been increasing. In the first wave of cases, the first metatarsophalangeal joint was involved in 82.1% of all cases; no fourth metatarsophalangeal joint involvement had been observed. Hyperlipemia was the most common accompanying abnormal laboratory test (57.1%). Radiographic bone erosion was found in 49.4% patients, most of them with disease duration more than 5 years.
CONCLUSIONSThe prevalence of primary gout in Shantou area has been increasing in the last ten years. Changes in diet and lifestyle may be responsible for this rapid increase.
Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Gout ; complications ; diagnostic imaging ; epidemiology ; Humans ; Male ; Middle Aged ; Radiography
8.Calcium pyrophosphate crystal deposition disease:report of two cases.
Zhi-ming JIANG ; Hui-zhen ZHANG
Chinese Journal of Pathology 2009;38(12):848-849
Calcium Pyrophosphate
;
metabolism
;
Cartilage, Articular
;
metabolism
;
pathology
;
Chondrocalcinosis
;
diagnostic imaging
;
metabolism
;
pathology
;
surgery
;
Diagnosis, Differential
;
Female
;
Gout
;
pathology
;
Humans
;
Knee Joint
;
diagnostic imaging
;
metabolism
;
pathology
;
Male
;
Menisci, Tibial
;
metabolism
;
pathology
;
Middle Aged
;
Osteoarthritis
;
etiology
;
pathology
;
Radiography
9.Application of dual-energy computed tomography for detecting uric acid deposition in patients with gout.
Wei LIU ; Hua-dan XUE ; Xue-jun ZENG ; Hao SUN ; Xuan WANG ; Yu CHEN ; Yun-qiang ZHANG ; Kai XU ; Zheng-yu JIN
Acta Academiae Medicinae Sinicae 2010;32(6):645-648
OBJECTIVETo assess the value of dual energy computed tomography (DECT) for the detection of uric acid (UA) deposition in patients with gout.
METHODSA total of 37 patients with tophaceous gout (including 8 crystal-proven cases) and 10 control patients (5 with unknown arthropathy, 3 with rheumatoid arthritis, and 2 with osteoarthritis) were included. DECT was performed for all peripheral joints (wrists, hands, elbows, knees, ankles and feet) . Color coding was used to display the localization of UA deposition. Images were reviewed independently by two trained radiologists.
RESULTSWith DECT, patients with gout were found to have UA deposits in hands and wrists 46% (17/37) , elbows 16% (6/37) , knees 27% (10/37) , ankles and feet 89% (33/37) . No UA deposit was observed in all 10 control patients (P=0.000) . Among the 37 patients with gout, the number of UA deposition sites detected by DECT (n=297) was 2.25 times of that detected by physical examinations (n=132) (P=0.000) .
CONCLUSIONSDECT allows the visualization of UA deposition in gouty arthropathy. Even subclinical disease can be delineated with this technique. However, the accuracy of DECT requires further investigations.
Adult ; Aged ; Aged, 80 and over ; Arthrography ; methods ; Extremities ; diagnostic imaging ; Female ; Gout ; diagnostic imaging ; metabolism ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods ; Uric Acid ; metabolism
10.Evaluation of penile hemodynamic status and adjustment of treatment alternatives in Peyronie's disease.
Tibet ERDOGRU ; Murat SAVAS ; Namik YILMAZ ; Mustafa Faruk USTA ; Turker KOKSAL ; Mutlu ATES ; Mehmet BAYKARA
Asian Journal of Andrology 2002;4(3):187-190
AIMErectile dysfunction may be observed in up to 80% of patients with Peyronie's disease. An objective evaluation of the erectile function is attempted to work out in patients with Peyronie's disease.
METHODSPenile deformity, sexual function and penile vascular status were analyzed in 123 patients with Peyronie's disease, who had not received any pertinent treatment.
RESULTSPenile deformity, palpable plaque and pain on erection were seen in 112 (91%), 97 (78.8%) and 27 (21.9%) of the 123 patients, respectively. Of the 76 patients evaluated by color Doppler ultrasounography, veno-occlusive dysfunction as the vascular component for erectile dysfunction was found in 17 (22.3%), arterial insufficiency in 10 (13.1%) and a mixed picture in 23 (30.2%).
CONCLUSIONThe documentation of penile erectile function and the determination of the vascular status using color Doppler ultrasonography can guide the appropriate therapeutic choice.
Adult ; Aged ; Antioxidants ; therapeutic use ; Colchicine ; therapeutic use ; Erectile Dysfunction ; diagnostic imaging ; drug therapy ; physiopathology ; Gout Suppressants ; therapeutic use ; Humans ; Male ; Middle Aged ; Penile Induration ; diagnostic imaging ; drug therapy ; physiopathology ; Penis ; blood supply ; pathology ; physiopathology ; Ultrasonography, Doppler, Color ; Vitamin E ; therapeutic use