COMPUTED-TOMOGRAPHY OF THE KNEE-JOINT AS AN INDICATOR OF INTRAARTICULAR TOPHI IN GOUT

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.