Use of imaging to evaluate gout and other crystal deposition disorders

Curr Opin Rheumatol. 2009 Mar;21(2):124-31. doi: 10.1097/BOR.0b013e3283257b6c.


Purpose of review: This review summarizes recent advances in plain radiography and advanced imaging for gout, calcium pyrophosphate dihydrate crystal arthropathy and basic calcium phosphate crystal arthropathy.

Recent findings: Plain radiography has diagnostic utility in the crystal-induced arthropathies. A gout radiographic damage index has been recently validated. High-resolution ultrasonography may improve noninvasive diagnosis of the crystal-induced arthropathies, and allow monitoring of intra-articular tophi in clinical trials. Computed tomography provides excellent definition of tophi and bone erosion, and three-dimensional computed tomography assessment of tophus volume is a promising outcome measure in gout. Magnetic resonance imaging is also a reliable method for assessment of tophus size in gout, and has an important role in detection of complications of disease in clinical practice. Emerging imaging techniques include three-dimensional ultrasonography and dual-energy computed tomography. Advanced imaging modalities also offer new insights into the mechanisms of cartilage and bone damage in the crystal-induced arthropathies.

Summary: Plain radiography and advanced imaging techniques may assist with diagnosis, assessment of disease complications and monitoring of crystal-induced arthropathies. Further study of these techniques will provide significant improvement in patient care and further aid in the understanding of disease pathogenesis.

Publication types

  • Review

MeSH terms

  • Bone and Bones / pathology
  • Calcium Pyrophosphate / metabolism
  • Cartilage, Articular / pathology
  • Crystallization
  • Gout / diagnosis*
  • Gout / diagnostic imaging
  • Gout / metabolism
  • Humans
  • Imaging, Three-Dimensional
  • Joints / pathology
  • Magnetic Resonance Imaging
  • Radiographic Image Interpretation, Computer-Assisted
  • Tomography, X-Ray Computed
  • Ultrasonography


  • Calcium Pyrophosphate