The value of musculoskeletal ultrasound in predicting gout flares in index joints: A prospective cohort study of people with gout starting urate-lowering therapy
Authors' conclusion
Ultrasound features of MSU crystal deposition at the MTP1 and knee predict subsequent risk of frequent gout flares in the same joints following initiation of urate-lowering therapy, with the highest risk in those with high tophus scores.
Study context
- Population
- People with at least one gout flare involving the MTP1, ankle or knee joint, starting ULT
- Exposure
- Ultrasound findings of monosodium urate (MSU) crystal deposition (OMERACT scores) present vs absent in the index joint
- Outcome
- Frequent (≥2) gout flares in the index joint
- Follow-up
- 12 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Frequent (≥2) flares in index joint, US finding present vs absent
- MTP1, tophus: 85.0% vs 46.0%
- P < 0.001
- MTP1, aggregates: 78.8% vs 59.0%
- P < 0.01
- Ankle, tophus: 54.6% vs 20.8%
- P < 0.001
- Ankle, aggregates: 60.0% vs 35.9%
- P < 0.05
- Knee, tophus: 68.4% vs 28.6%
- P < 0.05
Observational data: associations, not effects.
Further findings
MTP1: odds of frequent flares per 1-point increase in tophus score (fold increases, respectively) · 12 months
- Fold increase
- 5.19 (95%CI: 1.26-21.41)
- Fold increase
- 7.91 (95%CI: 2.23-28.14)
- Fold increase
- 13.79 (95%CI: 3.79-50.20)
Ankle: tophus score of 3 and frequent flares · 12 months
- OR
- 9.24 (95%CI=2.85-29.91)
Semi-quantitative sum scores and frequent flares · 12 months
- MTP1, OR (95%CI 3.44-54.18), P < 0.001
- 13.66
- Ankle, OR (95%CI 1.98-25.12), P < 0.001
- 7.05
Original publication
The value of musculoskeletal ultrasound in predicting gout flares in index joints: A prospective cohort study of people with gout starting urate-lowering therapy. Semin Arthritis Rheum. Published 18 February 2024. doi:10.
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