Gadolinium-enhanced MRI features of acute gouty arthritis on top of chronic gouty involvement in different joints

Yasser Emad*, Yasser Ragab, Ahmed El-Naggar, Nashwa El-Shaarawy, Mayada A. Abd-Allah, Rania M. Gamal, Ahmed Fathy, Mona Hawass, Johannes J. Rasker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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The aims of the current study are to describe gadolinium-enhanced MRI features of an acute flare of established gouty arthritis in different joints and to examine a possible association between serum uric acid and MRI signs indicative of ongoing inflammation and/or structural joint damage as well as association with disease characteristics and laboratory findings. Twenty-seven male patients with established chronic gout agreed to participate, mean age 47.6 years, and mean disease duration in months 43.2 (±31.8). For all patients, detailed demographic, disease characteristics, and laboratory findings were obtained and correlated with MRI findings. In 27 patients with established gout, a total of 50 MRI studies were performed of the following joints: feet joints (n = 23), ankles (n = 18), knees (n = 5), and hand and wrist joints (n = 4). MRI revealed capsular thickening in 19 patients, bone marrow edema (BME) in 15, soft tissue edema (STE) in 20, joint effusion in 21, bone erosions in 17, cartilaginous erosions in 4, and tenosynovitis in 9 cases. In 17 cases, tophaceous lesions were found. Post contrast MRI showed synovial thickening in seven cases. Positive correlations were observed between serum uric acid levels and the following MRI findings: capsular thickening (r = 0.552, p = 0.003), BME (r = 0.668, p ≤ 0.0001), STE (r = 0.559, p = 0.002), and tenosynovitis (r = 0.513, p = 0.006). Using MRI in chronic gout, important features can be detected like BME, minute cartilaginous erosions, and hypertrophic synovial inflammation in post contrast MR images. Serum uric acid (SUA) was positively correlated with capsular thickening, BME, STE, and tenosynovitis.
Original languageEnglish
Pages (from-to)1939-1947
JournalClinical rheumatology
Issue number11
Early online date14 Feb 2015
Publication statusPublished - Nov 2015


  • Bone marrow edema in gouty arthritis
  • Gout
  • Gouty arthritis
  • MRI in gouty arthritis
  • Tophaceous gout
  • n/a OA procedure


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