Two of seven (29%) joints not initially associated with hammertoe developed a mild hammertoe deformity from time of diagnosis to follow-up. At follow-up evaluation (18 +/- 9 months, range 4-26 months), the involved MP joint was asymptomatic in nine joints (60%), improved or almost asymptomatic in five joints (33%), and operated in one (7%) joint. Treatment included intra-articular corticosteroid injection and rocker-sole show modification to limit MP joint dorsiflexion. Examination revealed tenderness and palpable fullness of the MP joint in all cases painful dorsal drawer sign was present in 10 cases (67%), adjacent interdigital tenderness in six cases (40%), and hammertoe deformity in eight cases (53%). The second MP joint was involved in nine cases (60%), and the third was involved in six cases (40%). Average duration of forefoot pain was 4 +/- 3 months (range 0.5-12 months), except for one patient who had pain for 30 months. Conclusions Four-joint investigation (both first metatarsophalangeal joints for tophi and both ankles for the DC sign) is feasible and reliable and could be proposed as a screening test for early ultrasonographic gout classification in daily practice.The results of nonoperative treatment of metatarsophalangeal (MP) joint synovitis in 13 patients without known rheumatologic conditions (15 joints) were reviewed. The inter-reader reliability kappa value for the DC sign and tophi was 0.712. Binary logistic regression analysis showed that two ultrasonographic signs (tophi in the first metatarsophalangeal joint and the DC sign in the ankle ) significantly contributed to the final model for early gout diagnosis (sensitivity and specificity of 84% and 81%, respectively). Results Ultrasonographic sensitivity was lower in early than late gout. Standardized blinded ultrasound examination of 36 joints and the triceps and patellar tendons was performed to identify tophi and the double contour (DC) sign. Methods Sixty patients with monosodium urate crystal-proven gout (25 with early gout, 35 with late gout, and 36 normouricemic healthy controls) from one centre were prospectively evaluated. Objective To identify the optimal sites for classification of early gout by ultrasonography. 2017 Jan 1:300060517706800.Īn optimal ultrasonographic diagnostic test for early gout: A prospective controlled study. Journal of International Medical Research. Norkuviene E, Petraitis M, Apanaviciene I, Virviciute D, Baranauskaite A.
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