Dual‐energy computed tomography (DECT) is a relatively recent development in the imaging of gouty arthritis. Its availability and usage have become increasingly widespread in recent years. DECT is a non‐invasive method for the visualisation, characterisation and quantification of monosodium urate crystal deposits which aids the clinician in the early diagnosis, treatment and follow‐up of this condition. This article aims to give an up to date review and summary of existing literature on the role and accuracy of DECT in the imaging of gout. Techniques in image acquisition, processing and interpretation will be discussed along with pitfalls, artefacts and clinical applications.
A 48-year-old woman presented with chronic right heel pain of two months' duration that had responded poorly to physiotherapy and conservative measures. Clinical assessment revealed exquisite tenderness over the medial calcaneal tuberosity as well as paraesthesia over the sole of the forefoot. Relative weakness of the abductor digiti minimi (ADM) was elicited. The Achilles tendon, alignment of the hindfoot, and the longitudinal arches were assessed to be normal. Magnetic resonance (MR) imaging of the right foot was performed. What do the MR images (Figs. 1 & 2) and lateral radiograph (Fig. 3) of the right foot show? CMEArticle
The clinical diagnosis of musculoskeletal infections can be challenging due to non-specific signs and symptoms on presentation. These infections include infectious myositis, necrotising fasciitis, septic arthritis, septic bursitis, suppurative tenosynovitis, osteomyelitis, spondylodiscitis and periprosthetic infections. Diagnostic imaging is routinely employed as part of the investigative pathway to characterise the underlying infectious disease pattern, allowing expedited and customised patient management plans to optimise outcomes. This article provides an update on the various imaging modalities comprising of radiography, computed tomography, ultrasonography, magnetic resonance imaging and radionuclide procedures, and incorporates representative images of key findings in the different forms of musculoskeletal infections.
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