Gout chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

An x-ray is done when gout is suspected to rule out other abnormalities of the bone that may be causing the pain. Most commonly in gout, the x-ray will show no abnormalities, or a small amount of soft tissue swelling.

X-ray

  • Plain radiographs are often normal, although evidence of asymmetrical swelling and subcortical cysts without erosion may help to diagnose chronic gout.[1]
  • Radiographic changes are a late feature of chronic gout, typically occurring after 15 years of disease onset, and is almost always present in patients with subcutaneous tophi.[2]
  • Bone erosion is a feature of advanced gout and is characterized by a sclerotic rim and overhanging edge.[3]
  • The joint space is usually preserved until late in the disease, and other features such as periosteal new bone formation, extra-articular erosions, intraosseous calcifications, joint space widening, and subchondral collapse may be present.[4]

Patient #1

Patient #2

Sources

Copyleft images obtained courtesy of RadsWiki [2]

References

  1. Zhang W, Doherty M, Pascual E, Bardin T, Barskova V, Conaghan P, Gerster J, Jacobs J, Leeb B, Lioté F, McCarthy G, Netter P, Nuki G, Perez-Ruiz F, Pignone A, Pimentão J, Punzi L, Roddy E, Uhlig T, Zimmermann-Gòrska I (October 2006). "EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)". Ann. Rheum. Dis. 65 (10): 1301–11. doi:10.1136/ard.2006.055251. PMC 1798330. PMID 16707533.
  2. Nakayama, Denny A.; Barthelemy, Carl; Carrera, Guillermo; Lightfoot, Robert W.; Wortmann, Robert L. (1984). "Tophaceous Gout: A Clinical and Radiographic Assessment". Arthritis & Rheumatism. 27 (4): 468–471. doi:10.1002/art.1780270417. ISSN 0004-3591.
  3. Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, Brown M, Choi H, Edwards NL, Janssens HJ, Lioté F, Naden RP, Nuki G, Ogdie A, Perez-Ruiz F, Saag K, Singh JA, Sundy JS, Tausche AK, Vaquez-Mellado J, Yarows SA, Taylor WJ (October 2015). "2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative". Ann. Rheum. Dis. 74 (10): 1789–98. doi:10.1136/annrheumdis-2015-208237. PMC 4602275. PMID 26359487.
  4. Resnick D, Broderick TW (December 1981). "Intraosseous calcifications in tophaceous gout". AJR Am J Roentgenol. 137 (6): 1157–61. doi:10.2214/ajr.137.6.1157. PMID 6976085.

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