ROLE OF MUSCULOSKELETAL ULTRASOUND IN THE EVALUATION OF JOINT PATHOLOGIES IN PATIENTS WITH HYPERURICEMIA AND GOUT- A ONE YEAR HOSPITAL BASED CROSS SECTIONAL STUDY

Abstract

Background: Hyperuricemia is defined as raise in serum uric acid levels (monosodium urate). Deposition of monosodium urate in the form of crystals, within the tissues results in an inflammatory response termed as gout. Gouty arthritis is one of the commonest inflammatory joint diseases and appears to be rapidly increasing worldwide. Higher prevalence is seen in men and incidence increases with age. The cartilaginous deposits which are characteristic are not readily demonstrated with conventional diagnostic imaging including roentgenography, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). The sensitivity of simple radiography of the involved joint is found to be low. Though Computed Tomography and Magnetic Resonance Imaging has the advantages of early detection of tophi and bone erosion, the disadvantages include inconvenience to the patients, exposure to the radiation (CT), high cost and lack of specificity (MRI). [2] Demonstration of monosodium urate crystals under polarizing microscope from the joint or tophi aspirate is gold standard for the diagnosis of gout. But it is an invasive procedure and is infrequently done. [2] Ultrasound has emerged as a useful non-invasive tool for the diagnosis of gout. It can also be used to evaluate the involvement of joints in the patients with hyperuricemia which aids in the clinical management and thus alters the disease progression.