CRYSTAL DEPOSITION DISEASES: Edited by Robert TerkeltaubUse of ultrasound for diagnosis and monitoring of outcomes in crystal arthropathiesGrassi, Waltera; Okano, Tadashia,b; Filippucci, EmilioaAuthor Information aClinica Reumatologica, Università Politecnica delle Marche, Ospedale C Urbani Via dei Colli, Jesi (Ancona), Italy bDepartment of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Japan Correspondence to Walter Grassi, Clinica Reumatologica, Università Politecnica delle Marche, Ospedale C Urbani, Via dei Colli 52, 60035 Jesi, Ancona, Italy. Tel: +39 0731534125; e-mail: [email protected] Current Opinion in Rheumatology: March 2015 - Volume 27 - Issue 2 - p 147-155 doi: 10.1097/BOR.0000000000000142 Buy Metrics Abstract Purpose of review In the latest recommendations for the diagnosis and management of gout and calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, the diagnostic potential of ultrasound has been recognized. This review highlights the recent advances of research on ultrasound in gout and CPPD crystal deposition disease. Recent findings Ultrasound allows highly sensitive, noninvasive and quick detection of microcrystal aggregates in multiple anatomic areas. Ultrasound can be used as a safe and reliable guide to aspirate even minimal fluid collections suitable for microscopic analysis, and as a tool for monitoring monosodium urate crystal dissolution induced by urate-lowering therapy. The first metatarsophalangeal joint and the knee should be regarded as the anatomic regions with the highest probability of being respectively positive for monosodium urate and CPPD crystal aggregates. Summary The detection of highly evocative signs in patients with equivocal clinical findings may have a deep impact on the clinical decision-making process, narrowing the differential diagnostic spectrum and avoiding time-consuming and expensive diagnostic procedures. Ultrasound differential diagnosis between gout and CPPD crystal deposition disease is based on the characteristics of crystal aggregates and their preferential localization in different anatomical areas. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.