Performance of Musculoskeletal Ultrasound in screening for Gouty Arthritis in Chronic Kidney Disease Patients

Abstract

Background: Gout is a metabolic disorder characterized by disturbance in purine metabolism and urate excretion with manifestations of acute and chronic arthritis and tophus formation. Aim of work: To evaluate the role of musculoskeletal ultrasound (MSUS) in early detection of gout in CKD patients. Subject and methods: This study was carried out on 50 patients with CKD according to K/DOQI classification of CKD. Musculoskeletal ultrasound assessment for wrists, hands, feet and knees joints was done for all patients then they were divided into 2 groups according to presence or absence of MSUS specific findings of gout as double contour sign (DCS) and/or tophus formation. Statistical analysis carried out for all collected data using SPSS statistical significance was determined at as P value < 0.05. Results: Using MSUS revealed that 35 patients (70%) had positive ultrasound findings for gouty arthritis. 10 of this group (28.6 %) were non hyperuricemic. The group of patients with positive sonographic findings had significant higher serum uric acid and older age than other group (P value =0.004), (P value < 0.001) respectively. MSUS reveled sensitivity 80 % and specificity 47 % in the detection of gout in patient with CKD. Conclusion: MSUS is considered a reliable tool with high sensitivity in screening of gouty arthritis in asymptomatic hyperuricemic patients.