Comparison of sonographic appearance of normal control, gout and chondrocalcinosis in knee joints. Suprapatellar, transverse view in flexion. Schematic illustrations on left. Top: anechoic (black) layer of hyaline cartilage (c) overlying bony contour of distal femur (b). Middle: double contour sign. Hyperechoic (bright), slightly irregular layer of crystal deposits (open arrowheads) overlying anechoic hyaline cartilage (c) and bony contour of distal femur (b). This patient had crystal-proven, untreated gouty arthritis. The hyaline cartilage is thin in this 88-yr-old individual. Bottom: hyperechoic, crystalline material (asterisks) is layered in the centre of the anechoic hyaline cartilage (c). This layer parallels the outline of the bony cortex (b). Calcium pyrophosphate crystals were found on aspiration.
source: http://www.medscape.com/viewarticle/561112_4
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