In patients with acute mono/oligoarthritis, a targeted ultrasound scanning protocol shows great accuracy for the diagnosis of gout and CPPD
Authors' conclusion
A targeted US scanning protocol of two joints bilaterally plus the target joint showed an excellent accuracy (>90%) for the diagnosis of crystal arthritis in patients with acute mono/oligoarthritis.
Study context
- Population
- Patients with acute mono/oligo-arthritis of unknown origin in whom joint aspiration at the most clinically involved joint was requested32 gout, 30 CPPD, 99 disease-controls
- Participants
- 161 patients
- Comparison
- Targeted US scanning protocol (two joints bilaterally plus target joint) vs US of the target joint only, against joint aspiration
- Outcome
- Diagnostic accuracy of US findings and scanning protocols for gout and CPPD
Methodological detailsconsecutive enrolment
- Consecutive enrolment
Performance
As reported in the abstract
Diagnostic accuracy for gout
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| Targeted US protocol | 0.91 | 0.91 | 0.91 |
| Target joint US | 0.84 | — not stated in the abstract | — not stated in the abstract |
AUC
Targeted US protocol0.91
Target joint US0.84
Sensitivity
Targeted US protocol0.91
Target joint US— not stated in the abstract
Specificity
Targeted US protocol0.91
Target joint US— not stated in the abstract
— not stated in the abstract
- Targeted US protocol vs Target joint US: P = 0.03 — AUC 0.91 vs 0.84
Further findings
| Outcome | Targeted US protocol | Target joint US | P value |
|---|---|---|---|
| Diagnostic accuracy for CPPDNot higher where the target joint was the knee or wrist | |||
| Sensitivity | 0.93 | — not stated in the abstract | |
| Specificity | 0.89 | — not stated in the abstract | |
| AUC | 0.93 | 0.84 | P = 0.04 |
— not stated in the abstract
Individual US findings for gout
- Specificity
- 0.92-0.96
- Sensitivity, double contour sign
- 0.73
- Sensitivity, tophi
- 0.85
Individual US findings for CPPD
- Specificity
- 0.90-0.97
- Sensitivity, hyaline cartilage deposits
- 0.60
- Sensitivity, fibrocartilage deposits
- 0.90
Original publication
In patients with acute mono/oligoarthritis, a targeted ultrasound scanning protocol shows great accuracy for the diagnosis of gout and CPPD. Rheumatology (Oxford). Published 23 August 2022. doi:10.
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