A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout
Objective To characterize in detail the structural bone changes associated with the deposition of monosodium urate crystals in the first metatarsophalangeal (MTP1) joint in patients with tophaceous gout. Methods Twenty patients with tophaceous gout and involvement of the MTP1 joint received both dua...
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doaj-16e3b8bd45904aaf8569e88116b6948f2020-11-25T04:00:57ZengWileyACR Open Rheumatology2578-57452020-10-0121056557210.1002/acr2.11172A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in GoutCaroline Pecherstorfer0David Simon1Sara Unbehend2Hanna Ellmann3Matthias Englbrecht4Fabian Hartmann5Camille Figueiredo6Axel Hueber7Judith Haschka8Roland Kocijan9Arnd Kleyer10Georg Schett11Jürgen Rech12Sara Bayat13Friedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFaculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, and Friedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanySt. Vincent Hospital, Vienna, Austria and Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria, and Friedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyLudwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department Hanusch Hospital, Vienna, Austria, and Friedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyFriedrich‐Alexander‐University Erlangen‐Nuremberg, Erlangen, Germany and Universitätsklinikum Erlangen Erlangen GermanyObjective To characterize in detail the structural bone changes associated with the deposition of monosodium urate crystals in the first metatarsophalangeal (MTP1) joint in patients with tophaceous gout. Methods Twenty patients with tophaceous gout and involvement of the MTP1 joint received both dual‐energy computed tomography (DECT) of the feet for the detection of tophi and high‐resolution peripheral quantitative computed tomography (HR‐pQCT) of the feet for the detection of bone erosions and osteophytes. Demographic and clinical data were collected. Tophi in DECT and erosions and osteophytes in HR‐pQCT were overlayed to define their anatomical relation. In addition, the feet of 20 sex‐ and age‐matched healthy controls were scanned to define the normal architecture of the MTP1 joint. Results Patients with gout had an increased number and extent of bone erosions and osteophytes compared with their healthy counterparts (erosions: 5 [0‐17] vs 1 [1‐2], 45.32 mm3 [7.26‐550.32] vs 0.82 mm3 [0.15‐21.8]; osteophytes: 10.5 [0‐26] vs 1 [0‐10], 4.93 mm [0.77‐7.19 mm] vs 0.93 mm [0.05‐7.61 mm]; all P < 0.001). The median tophi volume detected by DECT (0.12 mm3 [0.01‐2.53]) was highly associated with the total volume of erosions (r = 0.597, P = 0.005). Conclusion Gout patients show increased changes in their bone microarchitecture. The extent of uric acid deposition is positively correlated with the extent of bone loss at the MTP1 joint, highlighting the strong cohesion of inflammation and erosive changes.https://doi.org/10.1002/acr2.11172 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Caroline Pecherstorfer David Simon Sara Unbehend Hanna Ellmann Matthias Englbrecht Fabian Hartmann Camille Figueiredo Axel Hueber Judith Haschka Roland Kocijan Arnd Kleyer Georg Schett Jürgen Rech Sara Bayat |
spellingShingle |
Caroline Pecherstorfer David Simon Sara Unbehend Hanna Ellmann Matthias Englbrecht Fabian Hartmann Camille Figueiredo Axel Hueber Judith Haschka Roland Kocijan Arnd Kleyer Georg Schett Jürgen Rech Sara Bayat A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout ACR Open Rheumatology |
author_facet |
Caroline Pecherstorfer David Simon Sara Unbehend Hanna Ellmann Matthias Englbrecht Fabian Hartmann Camille Figueiredo Axel Hueber Judith Haschka Roland Kocijan Arnd Kleyer Georg Schett Jürgen Rech Sara Bayat |
author_sort |
Caroline Pecherstorfer |
title |
A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout |
title_short |
A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout |
title_full |
A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout |
title_fullStr |
A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout |
title_full_unstemmed |
A Detailed Analysis of the Association between Urate Deposition and Erosions and Osteophytes in Gout |
title_sort |
detailed analysis of the association between urate deposition and erosions and osteophytes in gout |
publisher |
Wiley |
series |
ACR Open Rheumatology |
issn |
2578-5745 |
publishDate |
2020-10-01 |
description |
Objective To characterize in detail the structural bone changes associated with the deposition of monosodium urate crystals in the first metatarsophalangeal (MTP1) joint in patients with tophaceous gout. Methods Twenty patients with tophaceous gout and involvement of the MTP1 joint received both dual‐energy computed tomography (DECT) of the feet for the detection of tophi and high‐resolution peripheral quantitative computed tomography (HR‐pQCT) of the feet for the detection of bone erosions and osteophytes. Demographic and clinical data were collected. Tophi in DECT and erosions and osteophytes in HR‐pQCT were overlayed to define their anatomical relation. In addition, the feet of 20 sex‐ and age‐matched healthy controls were scanned to define the normal architecture of the MTP1 joint. Results Patients with gout had an increased number and extent of bone erosions and osteophytes compared with their healthy counterparts (erosions: 5 [0‐17] vs 1 [1‐2], 45.32 mm3 [7.26‐550.32] vs 0.82 mm3 [0.15‐21.8]; osteophytes: 10.5 [0‐26] vs 1 [0‐10], 4.93 mm [0.77‐7.19 mm] vs 0.93 mm [0.05‐7.61 mm]; all P < 0.001). The median tophi volume detected by DECT (0.12 mm3 [0.01‐2.53]) was highly associated with the total volume of erosions (r = 0.597, P = 0.005). Conclusion Gout patients show increased changes in their bone microarchitecture. The extent of uric acid deposition is positively correlated with the extent of bone loss at the MTP1 joint, highlighting the strong cohesion of inflammation and erosive changes. |
url |
https://doi.org/10.1002/acr2.11172 |
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