Integrating Musculoskeletal Ultrasound and Serological Markers to Optimize Acute Gouty Arthritis Diagnosis

This study aimed to evaluate the diagnostic utility of combining musculoskeletal ultrasound (MSUS) with serum levels of hypoxia-inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) for acute gouty arthritis (AGA).

The study included 122 patients hospitalized for gouty arthritis between February 2021 and February 2022. Of these, 60 patients presented with AGA, while 62 had non-acute gouty arthritis (NAGA). Semi-quantitative musculoskeletal ultrasound (MSUS) scores and serum levels of hypoxia-inducible factor-1α (HIF-1α) and cyclooxygenase-2 (COX-2) were compared between the two groups. A Disease Activity Score-28 (DAS28) was used to further classify the AGA group into low-activity and high-activity subgroups.

MSUS scores, DAS28, and serum levels of HIF-1α and COX-2 were significantly elevated in the AGA group compared to the NAGA group (p < 0.05). Furthermore, within the AGA group, the high-activity subgroup exhibited higher MSUS semi-quantitative scores, DAS28 scores, and serum levels of HIF-1α and COX-2 compared to the low-activity subgroup (p < 0.05). Pearson correlation analysis revealed a positive correlation between the MSUS semi-quantitative score and serum levels of HIF-1α, COX-2, as well as the DAS28 score in patients diagnosed with AGA (p < 0.05). The combined application of MSUS semi-quantitative scoring and serological markers provided significantly enhanced diagnostic accuracy for AGA and better assessment of disease activity compared to any individual marker.

MSUS and serum HIF-1α and COX-2 represent valuable tools for assessing the acute phase and disease activity of AGA. The combined diagnostic approach demonstrates superior effectiveness and holds potential for broader clinical application.