DROP

The importance of having a good ultrasound in our consultation.

It provides us with immediate non -invasive images which makes it easier for us to diagnose, follow the patient's evolution and the therapeutic treatment to follow.

The case we present is a male who goes to the consultation to perform annual control of its plantar supports.

When updating the anamnesis explains pain located in the first metatarsophalangeal articulation of the right foot of a month of evolution, which causes impotence and pain during wandering.

On physical examination, it presents the four most characteristic symptoms of the joint gout joints: pain, swelling, heat and redness.

Indeed, once barefoot and in standing we observe that the first finger (the gout usually affects the big toe) does not contact the soil due to the edema of said joint, redness and pain to the palpation.

In order to corroborate clinical diagnosis of gout we carry out an ultrasound study in which we visualize.

1.-The lack of congruence between the metatarsal head and the base of the first phalanx as a result of the total destruction of the joint.

2.-We observe a heterogeneous pattern with 2 differentiated masses that correspond to gouto (“gout”), inside they have more whitish parts corresponding to sodium urate deposits that produce a more intense ultrasound reflection than the reflection of the adjoining tissues, which allows them to be easily identified.

3.- We can also observe areas of peripheral hypervascularization in the affected joint.

Several studies show that the ultrasound exam has a greater sensitivity in the detection of suggestive findings of gout than the radiography or clinical exploration.

Author: Lara Alcedo Muñoz