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Proposed diagnostic algorithm
| First-line US | US finding | Implication |
|---|---|---|
| US positive | DC sign | Can diagnose gout |
| Tophus | ||
| Aggregates+DC sign | ||
| US negative | No arthritis signs | Can exclude gout |
| No synovitis | ||
| No edema | ||
| No echogenic deposits or DC sign | ||
| US inconclusive | Arthritis of unknown origin, but high clinical suspicion of gout | DECT |
| Echogenic deposits not typically seen for gout |
US, ultrasonography; DC, double contour; DECT, dual-energy computed tomography.
