Objectives To evaluate whether US findings indicating MSU deposits and US-detected inflammation (i.e. power Doppler signal) predict gout flares over 12 months. Methods Gout patients on urate-lowering therapy for at least the preceding 6 months were enrolled consecutively in this 12-month prospective, observational, single-centre study. A nested case–control analysis was performed. Cases were participants with at least one flare in the follow-up period, while controls did not self-report any gout flare. The US assessment included elbows, wrists, second MCP joints, knees, ankles, and first MTP joints. The US findings indicating MSU deposits [i.e. aggregates, double contour (DC) sign and tophi] were identified as present/absent according to the Outcome Measure in Rheumatology definitions. Power Doppler signal was scored semiquantitatively. Summated scores were calculated for each US finding. Results Eighty-one gout participants were enrolled, and 71 completed the study. Thirty (42.3%) of 71 participants experienced at least one flare over 12 months, with a median of 2.0 flares. Cases had a greater US burden of MSU deposits (6.7 ± 4.7 vs 2.9 ± 2.6, P = 0.01) and power Doppler signal (3.73 ± 3.53 vs 0.82 ± 1.44, P < 0.01) than controls, at baseline. The baseline US scores indicating MSU deposits and US-detected inflammation were significantly associated with the occurrence (total MSU score, adjusted odds ratio:1.75, 95% CI: 1.26, 2.43; power Doppler score, adjusted odds ratio: 1.63, 95% CI: 1.12, 2.40) and the number (total MSU score, adjusted incidence risk ratio: 1.17, 95% CI: 1.08, 1.26; power Doppler score, adjusted incidence risk ratio: 1.29, 95% CI: 1.19, 1.40) of flares over 12 months in multivariate analyses. Conclusions Baseline US findings indicating MSU deposits and US-detected inflammation are independent predictors of gout flares over 12 months.

中文翻译：

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超声检查预测痛风发作：一项为期 12 个月的前瞻性观察研究

目的 评估表明 MSU 沉积物的超声发现和超声检测到的炎症（即能量多普勒信号）是否可以预测 12 个月内的痛风发作。方法 在这项为期 12 个月的前瞻性、观察性、单中心研究中，连续纳入至少在前 6 个月接受降尿酸治疗的痛风患者。进行了嵌套病例对照分析。病例是在随访期间至少有一次痛风发作的参与者，而对照组没有自我报告任何痛风发作。美国评估包括肘部、手腕、第二个 MCP 关节、膝盖、脚踝和第一个 MTP 关节。根据风湿病学定义中的结果测量，表明 MSU 沉积物 [即聚集体、双轮廓 (DC) 征和痛风石] 的美国发现被确定为存在/不存在。半定量地对能量多普勒信号进行评分。计算每个美国发现的总分。结果 81 名痛风参与者入组，71 名完成了研究。71 名参与者中有 30 名 (42.3%) 在 12 个月内至少经历过一次突发事件，突发事件的中位数为 2.0 次。在基线时，病例的 MSU 沉积物（6.7 ± 4.7 对比 2.9 ± 2.6，P = 0.01）和能量多普勒信号（3.73 ± 3.53 对比 0.82 ± 1.44，P < 0.01）具有更大的美国负担。表明 MSU 沉积物和超声检测到的炎症的基线超声评分与发生显着相关（MSU 总评分，调整后的比值比：1.75，95% CI：1.26，2.43；能量多普勒评分，调整后的比值比：1.63，95% CI ：1.12，2.40）和数量（MSU 总分，调整后的发病风险比：1.17，95% CI：1.08，1.26；能量多普勒评分，调整后的发病风险比：1.29，95% CI：1.19，1。40) 在多变量分析中超过 12 个月的耀斑。结论 表明 MSU 沉积物和超声检测到的炎症的基线超声发现是 12 个月内痛风发作的独立预测因子。