Ultrasound of gout of the metacarpophalangeal joint

This longitudinal dorsal ultrasound scan of the second MCP joint shows thickened synovium with hyperechoic deposits (arrow) indicative of urate crystal deposition. The double contour sign at the metacarpal head (arrowhead) represents crystal deposition on the articular cartilage surface. The findings in this 56-year-old man with polyarthritis are consistent with gout.