Poster Session : PS 0668 ; Rheumatology ; New Grading Methods of Gout Tophi on Plain Radiography = Poster Session : PS 0668 ; Rheumatology ; New Grading Methods of Gout Tophi on Plain Radiography

다국어 초록 (Multilingual Abstract)

Background: Chronic gout is characterized by the presence of tophi, chronic granulomatous synovitis and bone erosion. Plain radiography remains the most widely used imaging modality in the clinical practice. In our knowledge, however, there have been no reported grading methods for gout tophi by plain radiography. Methods: 334 gout patients and had plain radiography of both 1st MTPJs included retrospectively. Gout tophi were defi ned as increased densities which are distinct from adjacent soft tissues. They were graded by measuring maximum diameters vertically and horizontally, and scored by adding up the scores of grades. The vertical diameter of tophi was measured at both sides of proximal phalanges (PPs). The horizontal diameter was measured at lateral side of PP. The measurement of maximum vertical diameter of tophi were graded as follows : grade 0, no tophi; grade 1, the presence of tophi is suspicious; grade 2, less than half of maximum vertical diameter of PP; grade 3, half or more of and less than the maximum vertical diameter of PP; grade 4, more than the maximum vertical diameter of PP. The maximum horizontal diameter of tophi was measured including the adjacent swollen soft tissues, and graded as follows: grade 0, no tophi; grade 1, less than half of maximum horizontal diameter of PP; grade 2, half or more of and less than the maximum horizontal diameter of PP; grade 3, more than the maximum horizontal diameter of PP (figure 1). Results: Points by new grading methods differed signifi cantly between the patient group having 6 mg/dL or more and the patient group having less than 6 mg/dL of serum urate level after treatment (p = 0.05). Conclusions: New grading methods of gout tophi by plain radiography is useful for evaluating changes of gout tophi after treatment.