- Involvement of axial skeleton is rare.
- Radiological changes are seen in 1-2 years after first clinical symtpoms.
- Joint space loss and periarticular osteopenia are commonly encountered.
- Tophi typically intensely enhance following gadolinium.
- On ultraound, 'double counter sign' is highly suggestive of gouty arthritis
Answers: T, F, F, T, T
- 1st MTPJ is the most common joint affected, followed by 1st IPJ and TMTJ. Lower limbs are more often affted than upper limbs. Feer, wrist and elbows are commonly affected. Axial skeleton is rarely affected.
- It takes 5-10 years to develop the radiological changes after first clinical symtpoms.
- Punched out periarticular erosion with overhanging margins are hallmark of gouty arthritis. The joint spaces are preserved till late stage. Periarticular osteopenia is not a feature of gout. In late stages, diffuse osteopenia may be seen.
- Tophi show low-to-intermediate signal on T1 and t2, and intensely enhance following contrast.
- 'Double counter sign' is seen as a hyperechoic irregular rim over the articular cartilage, and is considered a speific feature of gout, and is believed to be secondary to MSU crystals on the cartilage.
S. Dhanda, A re-look at an old disease: A multimodality review on gout, Clinical Radiology, Volume 66, Issue 10, October 2011, Pages 984-992