Imaging guidelines for gout and other crystalline joint diseases

Gout can be diagnosed clinically during an acute attack. In addition, imaging provides valuable information about the condition of joints that are not severely affected and about the damage that has already occurred. Recommendations for the use of imaging in gout and other crystalline arthropathies have now been summarized in a guide presented at the EULAR 2023 conference.

Crystal arthropathies (crystalline-induced arthropathies – CiA) represent a diverse group of diseases in which deposition of crystalline metabolites occurs in the joint cavity and subsequent arthritis. Uric acid or sodium urate (gout), calcium pyrophosphate crystals (chondral calcification), hydroxyapatite crystals (hydroxyapatite deposition disease) and homogenous acid (synchronous arthropathy) can crystallize in the joint cavities. Imaging can play an important role in the diagnosis of crystalline arthropathies, but it is by no means as trivial in this indication as Priv.-Doz. Dr. Peter Mandel of the Vienna University Clinic for Internal Medicine III. Diseases present clinically with acute episodes of arthritis, followed by asymptomatic episodes.

In its guidelines for the use of imaging in the diagnosis and follow-up of crystalline arthropathies, the EULAR Task Force has created guidelines with evidence-based recommendations. The task force consisted of 25 people from 11 countries with different professional and academic backgrounds. Four systematic literature searches of MEDLINE, EMBASE, and CENTRAL were designed to support the task force’s decisions on 14 questions, considering the indications for gout, chondrocalcinosis, and hydroxyapatite deposition disease.