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Gout - crystal deposition hyaline cartilage

Patient Positioning

Patient lies supine, knee 20°–30° flexed.  Place a small pillow under the joint to keep this position.

Probe Positioning

Place the transducer on a transverse plane in the midline over the quadriceps tendon.

note: patient with recurrent episodes of gouty arthritis of the knee (synovial fluid analysis with urate crystals). The ultrasound reveals irregular hyperechoic enhancement of the superficial margin of the hyaline cartilage (urate deposits) - not the cartilage interface sign (this arises due to the marked difference in acoustic impedances of the two tissues at the interface as a thin, regular hyperechoic line when the sound beam is perpendicular to the cartilage)