Diagnostic values of different musculoskeletal ultrasound signs, serum uric acid, and their combined detection for gouty arthritis

Abstract

Objectives: The study aimed to investigate the diagnostic values of different musculoskeletal ultrasound (MSUS) signs, serum uric acid (SUA), and their combined detection for gouty arthritis (GA).

Patients and methods: In this retrospective study, 70 patients (62 males, 8 females; mean age: 46.1±14.1 years; range, 25 to 86 years) diagnosed with GA (the GA group) between August 2022 and March 2023 and 70 patients (54 females, 16 males; mean age: 49.0±14.1 years; range, 21 to 75 years) diagnosed with rheumatoid arthritis and osteoarthritis during the same period (the non-GA group) were included. The positive rate of MSUS signs and SUA in both groups was recorded to compare the differences. The correlations of MSUS signs and SUA with GA were analyzed using Spearman’s rank correlation analysis. The diagnostic values of different MSUS signs, SUA, and their combined detection for GA were analyzed using a receiver operating characteristic, the area under the curve (AUC), sensitivity, specificity, and the Youden index.

Results: The positive rate of the double contour (DC) sign (chi-squared [χ² ]=102.935, p<0.001), hyperechoic spots (χ²=56.395, p<0.001), bone erosions (χ² =10.080, p<0.001), and SUA (χ² =41.117, p< 0.001) were higher in the GA group than in the non-GA group. The positive rate of the DC sign (rs=0.829, p=0.001), hyperechoic spots (rs=0.631, p<0.001), bone erosion (rs=0.268, p=0.001), and SUA (rs=0.542, p<0.001) were positively correlated with GA. Among the single-indicator measures, the DC sign exhibited the highest diagnostic value (AUC=0.907, sensitivity=81.4%, specificity=100%, p<0.001). Among the combined-indicator measures, the DC sign combined with SUA exhibited the highest diagnostic value (AUC=0.929, sensitivity=91.4%, specificity=94.3%, p<0.001), higher than DC sign detection alone.

Conclusion: The DC sign combined with SUA yielded a high diagnostic value and can thus provide a reliable basis for effectively and efficiently diagnosing GA.

Citation: Wu J, Yan J, Chang J, Li C, Xia B, Liu S, et al. Diagnostic values of different musculoskeletal ultrasound signs, serum uric acid, and their combined detection for gouty arthritis. Arch Rheumatol 2024;39(2):265-273. doi: 10.46497/ ArchRheumatol.2024.10366.

The study protocol was approved by the Zhejiang University School of Medicine Ethics Committee (date: 21.02.2023, no: K2023011). The study was conducted in accordance with the principles of the Declaration of Helsinki.

A written informed consent was obtained from each patient.

Contributed to conceptualization, data collection, data analysis, investigation, and manuscript writing: W.J.Y.; Contributed to conceptualization and ultrasound assessment: Y.J.L.; Contributed to conceptualization and clinical evaluation: C.J.; Contributed to data collection and data analysis: L.C.; Contributed to ultrasound assessment and manuscript revision: X.B.; Contributed to investigation and manuscript revision: L.S.N.; Contributed to conceptualization, manuscript revision, funding acquisition, and supervision: Z.X.J.; Contributed to conceptualization, manuscript revision, funding acquisition, and supervision: Z.Q.L.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

This work was supported by the Natural Science Foundation of Zhejiang Province under Grant number LGF22H180006, Jinhua Science and Technology Bureau under Grant number 2020-3-001, and Zhejiang Provincial Medical and Health Technology Plan under Grant number 2023KY841.

The data that support the findings of this study are available from the corresponding author upon reasonable request.