What is the sensitivity of the double contour sign for crystalline arthritis, gout, and calcium pyrophosphate deposition disease?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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The double contour sign is 85% sensitive and 80% specific for crystalline arthritis in general, with specificity for gout of 64% and for calcium pyrophosphate deposition disease of 52%. [108] The reliability of the double contour sign varies with the joint: femoral condyle sensitivity and specificity are 42% and 100%, respectively, compared with 62% and 98% for first metatarsals. [109]

Ultrasonography may demonstrate urate crystal deposition in tissues of asymptomatic patients with hyperuricemia. Pineda et al found double-contour signs in the first metatarsal-phalangeal joints of 25% of 50 asymptomatic patients with hyperuricemia but in none of 52 normouricemic subjects. [110]

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