Clinico-Radiological Profile of Joint Involvement in Hyperuricemia Patients
Creators
- 1. Resident / Fellow Department of Medicine, ERA's Lucknow Medical College and Hospital, Lucknow India
- 2. Professor, Department of Medicine, ERA's Lucknow Medical College and Hospital, Lucknow India
- 3. Department of Chemistry, Indian Institute of Technology Delhi, New Delhi, India
- 4. Division of Signaling and Gene Expression, La Jolla Institute for Immunology, La Jolla, CA, USA
- 5. Assistant Professor Department of Cardiology, ERA's Lucknow Medical College and Hospital, Lucknow India
Description
Introduction: Hyperuricemia is a condition characterized by abnormally elevated levels of serum uric acid. Symptoms are those of gout and nephrolithiasis. The gold standard for diagnosis of gout is identification of monosodium urate crystals in the synovial fluid, that is painful and leads to complications like joint effusion. In recent years with advancement of ultrasonography and dual energy computed tomography (DECT) new clinical picture and staging has been identified. The present study had been designed to study the clinical profile of hyperuricemia patients with regards to joint involvement as assessed by DECT and USG and comorbidities. Aim: To study the clinical profile of hyperuricemia patients with regards to joint involvement as assessed by DECT and USG and comorbidities. Material and Method: This was a cross sectional study which was done in Era’s Lucknow Medical College & Hospital, Lucknow. The study was carried out on diagnosed hyperuricemia patients attending the medicine OPD and indoor patients of Era’s Lucknow Medical College & Hospital in the last 18 months were included in the study till the required sample size was achieved. The overall sample size consisted of 66 cases of hyperuricemia. Results: The age of patients ranged from 36 to 87 years. Majority of the cases were aged more than 60 years. Further, majority of patients were females (56.1%). Only 19 (28.8%) patients were symptomatic with symptoms of pain, swelling and tenderness at joints were reported. Six patients had no comorbidities while rest 60 patients reported comorbidities. Diabetes alone (15.2%) was most common comorbidity. The radiological evidence of abnormalities which were indicative of involvement of joint by USG were DCS or HAG which were observed in 45.5% patients. MSU crystals were observed in 39.1% cases by DECT. So overall radiological evidence of joint involvement was found in 56.1% cases. No significant association of joint involvement was found with no of comorbidities, CAD, hypertension, T2DM and dyslipidemia. Significant association of S. uricemic acid was found only with joint involvement indicated by radiological findings. Conclusion: On the basis of these findings, it can be inferred that that asymptomatic patients (especially females and older) of hyperuricemia are at risk of developing joint involvement who should be radiologically examined. The overall prevalence of joint involvement in hyperuricemia patients was lying in the range (44.13 – 68.07) with 95% confidence. A confirmed relationship of Sr Uric Acid Levels (mg/dl) with Joint Involvement was found.
Abstract (English)
Introduction: Hyperuricemia is a condition characterized by abnormally elevated levels of serum uric acid. Symptoms are those of gout and nephrolithiasis. The gold standard for diagnosis of gout is identification of monosodium urate crystals in the synovial fluid, that is painful and leads to complications like joint effusion. In recent years with advancement of ultrasonography and dual energy computed tomography (DECT) new clinical picture and staging has been identified. The present study had been designed to study the clinical profile of hyperuricemia patients with regards to joint involvement as assessed by DECT and USG and comorbidities. Aim: To study the clinical profile of hyperuricemia patients with regards to joint involvement as assessed by DECT and USG and comorbidities. Material and Method: This was a cross sectional study which was done in Era’s Lucknow Medical College & Hospital, Lucknow. The study was carried out on diagnosed hyperuricemia patients attending the medicine OPD and indoor patients of Era’s Lucknow Medical College & Hospital in the last 18 months were included in the study till the required sample size was achieved. The overall sample size consisted of 66 cases of hyperuricemia. Results: The age of patients ranged from 36 to 87 years. Majority of the cases were aged more than 60 years. Further, majority of patients were females (56.1%). Only 19 (28.8%) patients were symptomatic with symptoms of pain, swelling and tenderness at joints were reported. Six patients had no comorbidities while rest 60 patients reported comorbidities. Diabetes alone (15.2%) was most common comorbidity. The radiological evidence of abnormalities which were indicative of involvement of joint by USG were DCS or HAG which were observed in 45.5% patients. MSU crystals were observed in 39.1% cases by DECT. So overall radiological evidence of joint involvement was found in 56.1% cases. No significant association of joint involvement was found with no of comorbidities, CAD, hypertension, T2DM and dyslipidemia. Significant association of S. uricemic acid was found only with joint involvement indicated by radiological findings. Conclusion: On the basis of these findings, it can be inferred that that asymptomatic patients (especially females and older) of hyperuricemia are at risk of developing joint involvement who should be radiologically examined. The overall prevalence of joint involvement in hyperuricemia patients was lying in the range (44.13 – 68.07) with 95% confidence. A confirmed relationship of Sr Uric Acid Levels (mg/dl) with Joint Involvement was found.
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IJPCR,Vol15,Issue4,Article21.pdf
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Additional details
Dates
- Accepted
-
2023-03-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue4,Article21.pdf
- Development Status
- Active
References
- 1. Roddy E, Zhang W, Doherty M. Is gout associated with reduced quality of life? A case-control study. Rheumat - ology. 2007;46:1441–1444. 2. Chen C, Lü J-M, Yao Q. Hyperuricemia-related diseases and xanthine oxidoreductase (XOR) inhibitors: an overview. Med Sci Monit. 2016; 22: 2501–2512. 3. Grassi D, Ferri L, Desideri G, Giosia PD, Cheli P, Pinto RD et al. Chronic Hyperuricemia, Uric Acid Deposit and Cardiovascular Risk. Curr Pharm Des. 2013; 19(13): 2432–2438. 4. Singh V, Gomez VV, Swamy SG. Approach to a Case of Hyperuricemia. Ind J Aerospace Med. 2010; 54(1): 40- 46. 5. Chhana A, Lee G, Dalbeth N. Factors influencing the crystallization of monosodium urate: a systematic literature review. BMC Musculo skelet Disord. 2015; 16: 296. 6. Chiodo CP, Logan C, Blauwet CA. Aspiration and Injection Techniques of the Lower Extremity. J Am Acad Orthop Surg. 2018 Aug 01;26(15): e31 3-e320. 7. Fernandes EA, Bergamaschi SB, Rodrigues TC, Dias GC, Malmann R, Ramos GM, et al. Relevant aspects of imaging in the diagnosis and management of gout. Revista brasileira de reumatologia. 2017 Jan - Feb;57 (1):64-72. 8. Nestorova R., Fodor D. Crystalinduced arthritis. In: El Miedany Y., editor. Musculoskeletal ultrasonography in rheumatic diseases. Springer International Publishing; Cham: 2015; 137–167. 9. Doherty M. New insights into the epidemiology of gout. Rheumatology 2009; 48(2): 112-118. 10. Younes TB, ELattar EA, Hamayed HFA, Elia RZ. Musculoskeletal ultrasonographic assessment of asymptomatic hyperuricemic Egyptian individuals. Egypt Rheumatol Rehabil. 2013; 40: 88–95. 11. Zhang Q, Gong H, Lin C, Liu Q, Baima Y, Wang Y, Lin J. The prevalence of gout and hyperuricemia in middle-aged and elderly people in Tibet Autonomous Region, China. Medicine (Baltimore). 2020; 99(2): e18542. 12. Bongartz T, Glazebrook KN, Kavros SJ, Murthy NS, Merry SP, Franz WB et al. Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. Annals of the Rheumatic Diseases. 2015;74:1072-1077. 13. Cao L, Zhao T, Xie C, Zheng S, Wan W, Zou H, Zhu X. Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia. Journal of Immunology Research. 2021; Vol. 2021; Article ID 5550626. 14. Abraham LL IV, Yasay E, Racaza G. Physician Practices in the management of Asymptomatic hyperuicemia. The 36th Annual Meeting of the Society for Medical Decision Making, October 2014, Miami FL. Available online at: https://www.researchgate.net/publication/268124090_PHYSICIAN_PRACTI CES_IN_THE_MANAGEMENT_OF _ASYMPTOMATIC_HYPERURICE MIA, last accessed 26th January, 2022. 15. Gruber M, Bodner G, Rath E, Supp G, Weber M, Schueller-Weidekamm C. Dual-energy computed tomography compared with ultrasound in the diagnosis of gout. Rheumatology (Oxford). 2014 Jan;53(1):173-9. 16. Kim EH, Jeon K, Park KW, Kim HJ, Ahn JK, Jeon CH, Cha HS, Koh EM. The Prevalence of Gout among Hyperuricemic Population. The Journal of the Korean Rheumatism Association. 2004; 11(1): 7-13. 17. Abdulhadi Z. T., & Muhsin Z. Y. Footprints to achieve digital smile design and esthetic: Narrative review. Journal of Medical Research and Health Sciences, 2023; 6(2): 2430– 2440.