[Radiologic findings in gout]

Radiological gout manifestations are detectable in the early stage, but also especially in the chronic stage of gout. Whereas in the early stage only soft tissue mutations (bursitis inflammation) and light calcium deposits are usually discernible, chronic gout leads to asymmetrical, diverse forms of osseous destruction, favouring smaller joints, but also affecting larger ones, which are caused by the intra-articular and extra-articular deposit of tophus material, corresponding to the progression and degree of severity of the illness. Radiologically-detectable changes in other organs, such as the kidneys, will be addressed. The high number of, and to some extent very characteristic, osseous mutations are compared with those mutations which are very similar to the diagnoses of other syndromes affecting the joints. Specifically, problems in differentiating diagnosis of rheumatoid arthritis, arthritis psoriatica, chondrocalcinosis, and other diseases of the joints will receive special mention. Reference is also made to the extreme diagnostic difficulties resulting from the rare but nevertheless conceivable influence of gout on the spine or sacroiliac joints. The method of magnetic resonance imaging for gout shows a characteristic signal behaviour of the tophus material. It has been determined that, through magnetic resonance tomography, interosseous tophi can be detected earlier and in a more widespread manner than with the aid of native X-ray images, such that an increase in the use of this method is to be expected.