คุณค่าของคลื่นเสียงความถี่สูงในการวินิจฉัยโรคเกาต์ในภาวะ ข้ออักเสบเฉียบพลัน

Abstract

Purpose: To evaluate the accuracy of ultrasonography in the diagnosis of gout presenting with acute arthritis. Materials and methods: The study retrospectively reviews of ultrasound images of patients with acute arthritis. Ultrasound features including double contour sign, hyperechoic spots in synovial fluid (snow storm appearance), hyperechoic spots in synovium, tophi, bone erosion and degree of synovial vascularity were recorded. The definite diagnosis of the disease was made by the results of synovial fluid examination. Sensitivity, specificity, positive predictive value, and negative predictive value of each feature were analyzed using patients with diagnosis other than gout (non-gout) as a control group. Results: Forty seven patients were presented acute arthritis. There were 23 patients (48.94%) with diagnosis of gout and 24 patients (51.06%) with non-gout. Ultrasound features revealed high specificity, range 75%-100% but low sensitivity (range from 13.04%-47.83%). Two signs with highest specificity were double contour sign and presence of tophi from US (91.67%).The most accuracy ultrasound finding is double contour sign which is highest sensitivity (47.83%), specificity (91.67%), PPV (84.63%) and NPV (64.71%). Conclusion: The results of our study indicate the ultrasound can play a relevant role in patients with acute gouty arthritis, particularly double contour sign. Keywords: Acute gouty arthritis, accuracy of ultrasonography, ultrasonography findings