ACCURATELY DETECTING AND MONITORING TOPHI

WITH PROFESSORS GEORG SCHETT, MD AND NICOLA DALBETH, MD

TRANSCRIPT

PROF. GEORG SCHETT, MD:

There's a lot of undertreatment and under recognition at the moment in gout. And that is actually leading to patients suffering. For me as a physician, I want to clear the patient of tophi. That, I think, is the ultimate goal we wish to have. And allow the patient to be free of relapses and flares.

PROF. NICOLA DALBETH, MD:

Flares are not necessarily an indication of intensity of deposition. We see people who have a lot of deposition, a lot of joint damage, who don't necessarily flare constantly.

I think what has been the big development in the last 10 years has been the development of advanced imaging tools, particularly dual-energy CT, conventional CT, and MRI actually also have taught us a lot, and also of course musculoskeletal ultrasound.

PROF. GEORG SCHETT, MD:

The mere inspection of a patient is not sufficient in chronic gout. We want to know what is actually the stage of the disease.

Images have been adapted with permission from Nicolaou S, et al. AJR Am J Roentgenol. 2012;199:S78-S86.1
Watch at 00:59

PROF. GEORG SCHETT, MD:

Dual-energy CT scans increase your possibility to find tophi, and I think they are much better than mere inspection.

PROF. NICOLA DALBETH, MD:

I think our understanding of the disease has really shifted as we've been able to visualize the disease better. If patients do have tophi, this is an excellent indication for urate-lowering therapy.

And I think, certainly for me, and I think in the work that I've done, the dual-energy CT has been really, I think, actually quite revolutionary in that space to help us understand that.

PROF. GEORG SCHETT, MD:

We should still inspect the patient of course, but we should use them as an add-on in a way to our diagnostic approach. They are helpful in monitoring the patient, you know. Is your therapy effective?

Because as you know, with different drugs you have different effects on the uric acid level, and that might also be important, how long you have to treat, to get rid of tophi. So, it's an enormous possibility also in monitoring of patients.

CHRONIC INFLAMMATION IN GOUT

Professors Nicola Dalbeth, MD and Georg Schett, MD examine the evidence of chronic inflammation in gout and its potential long-term effects.

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WHAT YOU CAN DO

Learn about a treatment option for chronic gout.

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Reference

  1. Nicolaou S, et al. AJR Am J Roentgenol. 2012;199:S78-S86.