Musculoskeletal Ultrasonography Identifies Structural Damage in Chronic Kidney Disease Patients with Gouty Arthritis

Zheng Hao Huang, Tony Szu Hsien Lee, Shu Yi Lin, Ya Chi Li, Fu Chiang Yeh, Chun Chi Lu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Renal insufficiency reduces the excretion of uric acid and inflammatory factors and exacerbates the structural deformities caused by gouty arthritis. Musculoskeletal ultrasonography (MSKUS) is often used to evaluate the severity and inflammatory progression of gout. Aim: We aimed to determine whether ultrasound help to identify structural damage in patients with chronic kidney disease (CKD) and gout. Methods: This was a retrospective review of the clinical manifestations and abnormalities observed with MSKUS in 280 patients with gouty arthritis between August 2004 and April 2017. MSKUS identified intra‑articular features, including joint effusion, synovial proliferation, Baker’s cysts, double contour sign, tophi, and extra‑articular tenosynovitis. Serum and synovial fluid were collected and analyzed. Significant differences were identified using the Pearson correlation coefficient and independent t-test. Results: This retrospective cohort included 257 men (91.8%) and 23 women (8.2%) with a mean age of 54.6 years. CKD stage correlated positively with the presence of joint Baker’s cyst (P = 0.004). Notably, serum estimated glomerular filtration rate correlated negatively with serum C‑reactive protein level in patients with CKD (P < 0.001), and more severe CKD correlated with a higher prevalence of Baker’s cyst in CKD patients (P = 0.0037). Conclusion: Insufficient control of hyperuricemia can lead to chronic gouty arthritis and subsequent structural deformities. Reciprocally, acute inflammation of joints is downregulated as chronic gouty arthritis develops. Patients with hyperuricemia and CKD should receive regular MSKUS examination to avoid the progression of structural damage in the joints.

Original languageEnglish
Pages (from-to)99-105
Number of pages7
JournalJournal of Medical Sciences (Taiwan)
Volume43
Issue number3
DOIs
Publication statusPublished - 2023 May

Keywords

  • Baker’s cyst
  • Gout
  • chronic kidney disease
  • musculoskeletal ultrasonography
  • synovial proliferation

ASJC Scopus subject areas

  • General Medicine

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