Jc. Gerster et al., COMPUTED-TOMOGRAPHY OF THE KNEE-JOINT AS AN INDICATOR OF INTRAARTICULAR TOPHI IN GOUT, Arthritis and rheumatism, 39(8), 1996, pp. 1406-1409
Objective. To evaluate the utility of computed tomography (CT) of the
knee joint for detecting intraarticular tophaceous deposits, Methods.
A prospective study of 16 patients with gout affecting the knee was co
nducted. A condition for inclusion in the study was the presence of ne
edle-shaped crystals with negative birefringence in the knee joint syn
ovial fluid, Conventional radiography and CT mere performed in each ca
se, Results. Intraarticular opacities in the capsule and the synovium,
consistent with the presence of tophaceous deposits, were found in 5
of the 16 patients (9 knee joints), The mean duration of gout was long
er in the patients with intraarticular tophi than in those without top
hi, and 2 of the patients with tophi had poor tolerance to antihyperur
icemic therapy. Conclusion. Intraarticular opacities considered to rep
resent tophi were observed in approximately one-third of the patients,
The presence of tophi correlated with a longer duration of the diseas
e and a poor tolerance to medication. We therefore suggest that CT of
the knees could be useful in the assessment and followup of certain pa
tients with gout.