Study of Musculoskeletal Ultrasound in the Differential Diagnosis and Clinical Characteristics of First-episode Gout and Asymptomatic Hyperuricemia
Objective To investigate the application and clinical characteristics of musculoskeletal ultrasound in the differential diagnosis of first-episode gout and asymptomatic hyperuricemia.Methods A total of 100 hospitalized and outpatient military patients with first-episode gout and asymptomatic hyperuricemia admitted to Joint Logistic Support Force Lushan Rehabilitation and Nursing Center from June 2022 to December 2023 were selected as the study group,and 100 military personnel with normal physical examination in the hospital during the same period were selected as the control group.The diagnostic value of musculoskeletal ultrasound was evaluated with clinical comprehensive diagnosis as the gold standard,the clinical characteristics of the patients in the study group were analyzed,and the risk factors of the onset of gout and asymptomatic hyperuricemia were analyzed by multivariate unconditional Logistic regression.Results All the 100 patients in the study group were examined by musculoskeletal ultrasound,and 48 patients were positive,the sensitivity was 90.20%(46/51),the specificity was 95.92%(47/49),the accuracy was 93.00%(93/100),the positive predictive value was 95.83%(46/48),and the negative predictive value was 90.38%(47/52).Kappa test showed that the consistency between musculoskeletal ultrasound and gold standard diagnosis was excellent(Kappa=0.818).The incidence of bone erosion,joint cavity effusion,soft tissue swelling,synovial thickening,double track sign and tophi in synovium in the study group was higher than that in the control group(P＜0.05).Multivariate unconditional logistic regression analysis showed that double-track sign and tophi were the influencing factors of the incidence of asymptomatic hyperuricemia(P＜0.05);the six characteristic sonograms of bone erosion,joint cavity effusion,soft tissue swelling,synovial thickening,double-track sign and tophi in synovium were all risk factors for the onset of gout(P＜0.05).Conclusion There are some differences in ultrasonic signs between first-episode gout and asymptomatic hyperuricemia,and musculoskeletal ultrasound has good value in the diagnosis and differential diagnosis of the two.
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