How to Differentiate Gout, Calcium Pyrophosphate Deposition Disease, and Osteoarthritis Using Just Four Clinical Parameters.
Dmitrij KravchenkoRaoul BergnerCharlotte BehningValentin Sebastian SchäferPublished in: Diagnostics (Basel, Switzerland) (2021)
Clinical differentiation between gout, osteoarthritis (OA), and calcium pyrophosphate deposition disease (CPPD) remains a hurdle in daily practice without imaging or arthrocentesis. We performed a retrospective analysis of consecutive patients with gout, CPPD, and OA at a tertiary rheumatology center. A total of 277 patients were enrolled, with 164 suffering from gout, 76 from CPPD, and 37 from OA. We used ANOVA and conditional inference tree analysis (Ctrees) to find associations between clinical, laboratory, and imaging data and gout, OA, and CPPD. The sonographic double contour sign was unable to differentiate gout from CPPD. Ctrees were able to exclude OA and CPPD as possible differentials based on elevated uric acid, C-reactive protein (CRP), presence of arterial hypertension, and sex, diagnosing gout with a sensitivity and specificity of 95.1% and 41.6%, respectively. Elevated CRP was observed using simple linear regressions in patients with type II diabetes, higher cumulative joint scores, increased number of affected joints, as well as elevated uric acid, erythrocyte sedimentation rate, and leukocyte count. Ctrees were able to differentiate gout, OA, and CPPD based on just four characteristics. Inflammatory response correlated with type II diabetes, more or larger joint involvement, and elevated uric acid levels.
Keyphrases
- uric acid
- metabolic syndrome
- knee osteoarthritis
- inflammatory response
- cardiovascular disease
- type diabetes
- high resolution
- rheumatoid arthritis
- primary care
- healthcare
- ejection fraction
- newly diagnosed
- insulin resistance
- systemic lupus erythematosus
- adipose tissue
- peripheral blood
- physical activity
- glycemic control
- lipopolysaccharide induced
- big data
- mass spectrometry
- fluorescence imaging
- deep learning
- toll like receptor
- photodynamic therapy
- single cell
- patient reported outcomes
- optical coherence tomography
- juvenile idiopathic arthritis
- patient reported