X-ray images of bone lesions in patients with chronic gout

The article was professionally consulted by Doctor Trinh Le Hong Minh - Radiologist - Radiology Department - Vinmec Central Park International General Hospital. The doctor has many years of experience in the field of diagnostic imaging.

In addition to clinical examination and performing tests, the image of bone lesions on X-rays can assess joint destruction due to chronic gout, thereby helping doctors to have a suitable treatment plan for each patient. patient.

1.1 What is chronic gout? If uric acid levels in the blood are high or cannot be eliminated, uric acid will accumulate in the form of urate crystals inside the body's tissues, especially in the synovial sacs and tissues around the joints. cause inflammation, severe joint pain. This condition is called gout.
1.2 Factors that increase the risk of gout There are many factors that can increase the risk of gout such as:
The patient uses too many foods rich in animal protein, foods containing a lot of purines such as seafood, heart Red eggs, animal organs, ... Having kidney diseases such as glomerulonephritis, kidney failure, ... reduces kidney function, leading to a decrease in the ability to filter uric acid out of the body. People who use drugs that increase uric acid levels in the blood such as diuretics, high blood pressure drugs, cell inhibitors to treat malignancies,... People with a family history have gout. 1.3 Stages of disease progression Along with socio-economic development and increasing life expectancy, gout tends to increase and become the most common arthritis in men. According to the natural progression, gout is divided into 3 stages which are:
Hyperuricemia without clinical symptoms Acute gout Chronic gout In which, chronic gout is a period of prolonged arthritis without any symptoms. stop. After the acute gout attack, the damaged joints do not return to normal but still swell, appear tophi, and at the same time, there are episodes of severe arthritis during this period.
Tophi appear due to prolonged deposition of urate crystals in the organizations, causing destruction of the organizational structure. Tophi often appear under the skin around joints and bursitis, especially on the outside of the ankle, around the knee, elbow, and metatarsophalangeal joints, along tendons in the hands and feet, and around the joints. proximal and distal joints of the hand.

In addition, tophi can appear in places not related to joints such as visceral (aortic valve, myocardium, pericardium), spinal epidural, and auricle.
Tophi are usually firm and mobile, and when broken, the tophi deposits are chalky, cream or yellow in color. The median time from the first gout attack to the appearance of tophi was 12 years. However, if hyperuricemia and risk factors are not well controlled, tophi can appear only 2 years after the onset of the disease.

To diagnose chronic gout, in addition to clinical examination to detect typical symptoms such as: polyarthritis often asymmetrical, joint swelling with deformity due to joint destruction due to tophi, accompanied by stiffness. Then the subclinical techniques such as laboratory tests, X-rays, ultrasound, ... are very valuable in assessing the disease status and the lesions caused by the disease.
X-ray images of bone lesions can assess joint destruction caused by chronic gout. Thereby, helping the doctor to have a suitable treatment plan for each patient.
Approximately 50% of gout patients present with bone changes on radiographs, usually 6-8 years after the first acute gout attack. For patients with subcutaneous tophi, there is almost always an X-ray change.
The image of bone lesions of chronic gout patients on X-ray films is usually: defects with holes (in the position of tophi), suggestive images are hook form, narrowing of the slit. joints, secondary bone spurs, sometimes there are many spines that destroy and deform the joint structure.

Chronic gout if not actively treated will cause complications that seriously affect the health and quality of life of the patient. In addition to joint damage such as: bone erosion, joint stiffness, joint destruction,... gout can cause kidney stones, kidney failure, affect vision,...
To limit the negative effects Due to the extremes of gout on health, patients should adhere to drug treatment under the guidance of their doctor. In addition, it is necessary to have a suitable diet and activity. Do not eat a lot of purine-rich foods such as sardines, herring, seafood, animal organs, ... limit eating animal fat, drink alcohol, use stimulants.

It is necessary to eat a lot of vegetables, fruits, drink a lot of water to enhance the elimination of uric acid through the urine. Regarding the lifestyle, it is necessary to increase physical activity, avoid a sedentary lifestyle, lose weight if you are overweight. Daily diet has a great influence on the treatment of the disease, so people with gout need to maintain a reasonable diet.
Vinmec International General Hospital is the address for examination, treatment and prevention of diseases. When performing the examination process at Vinmec, customers will be welcomed and used modern facilities and equipment along with perfect medical services under the guidance and advice of experts. Good doctors, well-trained both at home and abroad.
Especially when treating and examining patients at Vinmec, customers are also advised by the medical team on nutrition and lifestyle maintenance to prevent and treat in the most suitable way for their health.