MRI IN GOUT

The appearance of gouty tophus in magnetic resonance imaging (MRI) is characteristic. On T1- and T2-weighted SE images, the signal intensity of tophaceous lesions is similar to that of muscles. According to the histology, T2-weighted SE images demonstrate extremely hyperintense s ignals, which reflect the high protein content in the amorpheous cente r of the tophus. The microscopic urate crystals deposited there have n o MRI signal and are of no further diagnostic impact. Vascularized gra nulation surrounding the tophus center enhance after intervenous appli cation of contrast agents (Gadolinium). The inflammed tophus is associ ated with local edema, causing high signal intensity. MRI is superior to plain radiography for early detection of intraosseous tophi. Involv ement of anatomical structures such as ligaments and tendons can be ev aluated sufficiently. For peripheral joints, axial slice orientation i s most helpful.