Sonographic description and classification of tendinous involvement in relation to tophi in chronic tophaceous gout
Open Access
- 4 July 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in Insights into Imaging
- Vol. 1 (3), 143-148
- https://doi.org/10.1007/s13244-010-0031-x
Abstract
Objective: To describe and classify the varied ultrasound features of tendinous involvement in relation to tophi in chronic tophaceous gout so that they are better recognised.Methods: Ultrasound images of 138 affected areas from 31 patients with chronic tophaceous gout were analysed using high-quality broadband linear transducers. The relationship between tendon and tophi was classified, and the inter-observer agreement regarding classification was analysed.Results: Tophi envelopment in the tendon was the most frequent characteristic (45%) followed by no relationship between tophi and tendon (41%), tophi at the insertion site of the tendon (7%), extrinsic compression (6%) and tophi within the tendon (1%). The inter-observer concordance on classification of the relationship between tophi and tendon was measured using McNemar’s test withP < 0.001 (χ2 = 30.0, degree of freedom = 9) and kappa test = 0.627 (P < 0.001), indicating substantial inter-observer concordance.Conclusion: Tophi generally envelope the tendon or there is no relationship between them. Tophi can also be found at the insertion site of the tendon, cause extrinsic compression or be located inside the tendon. There is substantial inter-observer agreement for ultrasound classification of tendon involvement by tophi. This study contributes to diagnostic elucidation and shows the diverse characteristic forms of tendon involvement by tophi.Keywords
This publication has 20 references indexed in Scilit:
- Tophaceous Gout of the Rotator CuffJournal of Bone and Joint Surgery, 2008
- Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-rayEuropean Radiology, 2007
- Chronic Tophaceous Gout of the Third Flexor Digitorum Profundus Tendon in the Hand: An Unusual Sonography DiagnosisAmerican Journal of Roentgenology, 2006
- Longitudinal Tears of Both Peroneal Tendons Associated With Tophaceous Gouty Infiltration. A Case ReportThe Journal of Foot and Ankle Surgery, 2005
- Spontaneous rupture of extensor pollicis longus tendon with tophaceous gout infiltrationArchives of orthopaedic and trauma surgery, 2004
- Gout: a clinical and radiologic reviewRadiologic Clinics of North America, 2004
- Peritendinous lesions: The role of high-resolution ultrasonographyClinical Imaging, 2003
- Gouty Tenosynovitis and Compression Neuropathy of the Median NerveClinical Orthopaedics and Related Research, 1987
- Gouty involvement of a flexor tendon in the handThe Journal of Hand Surgery, 1983
- Preliminary criteria for the classification of the acute arthritis of primary goutArthritis & Rheumatism, 1977