Sonographic Assessments to Consider in Future Studies about Crystal-related Arthritis

Ultrasonography has shown a high sensitivity and specificity in the diagnosis of gout and chondrocalcinosis.

The author considers it appropriate to discuss a new ultrasound technique and previous sonographic findings in crystal-related arthritis that are underexplored.

MicroPure seems to be a very attractive tool in gout due to its crystal detection with less margin of error from artifacts. Similarly, sonographic measurements, such as the minimal-crystal distance and the quantitative echogenicity of calcium aggregates, might help in those patients with small deposits of calcium undetected in radiographs. Ultimately, patients with mixed-crystal arthritis by gout and chondrocalcinosis show a characteristic "triple-contour" sign described over a decade ago.

Studies to determine the usefulness of MicroPure, the minimal-crystal distance, and the quantitative echogenicity in crystal-induced arthritis are needed. "Triple-contour" sign should be considered as the best image in the screening of patients with suspected mixed-crystal arthritis by gout and chondrocalcinosis.