Musculoskeletal ultrasound (MSKUS) is a promising tool for diagnosis and treatment of gouty arthritis. It is useful to diagnose gout, monitor inflammatory status, and detect complications such as subtle bone erosion and tophus formation. It has a number of advantages over other imaging modalities, particularly the lack of ionizing radiation, relatively low cost, the dynamic assessment, and the ability to guide invasive procedures including synovial fluid aspiration and intra-articular (IA) drug delivery. On the other hand, it has a few disadvantages. It is an operator-dependent and it is more difficult to standardize imaging. X-ray is a standard imaging method and usually the first imaging procedure in gouty arthritis. However, its usefulness is limited, especially in early disease, because characteristic X-ray changes occur in advanced gout. MSKUS is known to be superior to conventional X- rays in evaluating small bone changes.
Kang et al. (2014) conclude that MSKUS is a useful tool to evaluate the joint abnormalities of MTPJ1 in acute gout attack, and MSKUS-guided IA corticosteroid injection of this joint appears to be an effective and safe therapeutic option.
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