Computed tomography of the knee joint as an indicator of intraarticular tophi in gout

Arthritis Rheum. 1996 Aug;39(8):1406-9. doi: 10.1002/art.1780390820.


Objective: To evaluate the utility of computed tomography (CT) of the knee joint for detecting intraarticular tophaceous deposits.

Methods: A prospective study of 16 patients with gout affecting the knee was conducted. A condition for inclusion in the study was the presence of needle-shaped crystals with negative birefringence in the knee joint synovial fluid. Conventional radiography and CT were performed in each case.

Results: Intraarticular opacities in the capsule and the synovium, consistent with the presence of tophaceous deposits, were found in 5 of the 16 patients (9 knee joints). The mean duration of gout was longer in the patients with intraarticular tophi than in those without tophi, and 2 of the patients with tophi had poor tolerance to antihyperuricemic therapy.

Conclusion: Intraarticular opacities considered to represent tophi were observed in approximately one-third of the patients. The presence of tophi correlated with a longer duration of the disease and a poor tolerance to medication. We therefore suggest that CT of the knees could be useful in the assessment and followup of certain patients with gout.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Gouty / diagnostic imaging*
  • Arthritis, Gouty / pathology
  • Cartilage / chemistry
  • Cartilage / pathology
  • Humans
  • Knee Joint / diagnostic imaging*
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed
  • Uric Acid


  • Uric Acid