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Tophaceous gout: quantitative evaluation by direct physical measurement
H Ralph Schumacher1, Michael A Becker, William A Palo
1Division of Rheumatology, University of Pennsylvania/Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA. schumacr@mail.med.upenn.edu
The Journal of Rheumatology
|December 7, 2005
Summary
A simple physical measurement for tophaceous gout tophi shows good reproducibility. This method can track treatment effectiveness in clinical trials and practice, despite some variability based on tophus location and rater experience.
Area of Science:
- Rheumatology
- Gout Management
- Clinical Measurement
Background:
- Standardized methods for monitoring tophaceous gout are lacking.
- This limits tracking tophus progression or regression effectively.
- A simple, direct physical measurement is needed.
Purpose of the Study:
- To assess the intra- and interrater reproducibility of a simple physical measurement for tophi.
- To evaluate the reliability of this method for monitoring tophaceous gout.
Main Methods:
- A multicenter study measured tophus area (mm²) independently by two raters on two occasions.
- Intra- and interrater reproducibility were calculated using mean differences and average percentage differences (APD).
Main Results:
- Fifty-two tophi were measured in 13 subjects.
- Mean APD between visits was 29% +/- 33%, and between raters was 32% +/- 27%.
- Variability was highest for elbow tophi and lowest for well-demarcated hand tophi.
Conclusions:
- The simple physical measurement method is reproducible and suitable for clinical trials and practice.
- Tophus anatomic site and rater experience influence measurement variability.
- Focusing on well-circumscribed tophi can enhance reliability for tracking treatment efficacy.