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Plain Radiography Can ID Changes in Gouty Tophi Size

Plain radiography can identify hypouricemic treatment response in patients with tophaceous gout

FRIDAY, Aug. 26, 2016 (HealthDay News) — For patients with tophaceous gout, plain radiography can assess response to hypouricemic treatment, according to a study published online Aug. 12 in the International Journal of Rheumatic Diseases.

Young Sun Suh, from the Gyeongsang National University School of Medicine in Jinju, South Korea, and colleagues examined whether plain radiography is useful for assessing gouty tophi size changes after hypouricemic therapy. Serum uric acid was measured before and after hypouricemic treatment, and gouty tophi size was measured with plain radiography. By measuring the maximum vertical and horizontal diameters, the tophi were graded, and they were scored by adding the scores of the grades. The authors assessed 700 first metatarsal phalangeal joints (MTPJs) of 350 patients with gout.

The researchers found that tophi were observed using plain radiography in 24.9 percent of MTPJs from 31.1 percent of patients. In 60 of these 109 patients, follow-up plain radiography was performed. The average serum uric acid level of these patients was 8.3 ± 1.9 mg/dL before treatment, and the average tophi score was 3.7 ± 2.5. The uric acid level decreased to 5.9 ± 1.6 mg/dL after hypouricemic treatment (P < 0.05), while the average tophi score declined to 1.5 ± 1.8 (P < 0.05).

“This new method for measuring gouty tophi using plain radiography may be useful for evaluating changes in gouty tophi size following hypouricemic treatment,” the authors write.

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