ENTHESOPATHY AND TENDINOPATHY IN GOUT - COMPUTED TOMOGRAPHIC ASSESSMENT

Objective-To establish if computed tomography (CT) imaging, which has proved helpful in detecting intra-articular tophi in gout, can also be used to document gouty enthesopathy and tendinopathy. Methods-Three p atients with tophaceous gout and clinical involvement of the Achilles tendon (two cases) or patellar tendon (one case) were assessed with CT examination and plain radiographs. Results-In the first two cases, CT images revealed linear or nodular high attenuation opacities within t he substance of the Achilles tendons and their calcaneal insertion. In case 3, dense linear opacities were seen within the patellar tendon a nd within its tibial insertion. No such opacities of the tendons and e ntheses were seen on standard radiographs of these patients. Conclusio ns-CT appears to be the imaging method of choice for demonstrating mon osodium urate deposits in entheses and tendons in tophaceous gout.