Diagnosing Gout with Dual-energy Computed Tomography: Principles, Diagnostic Performance, and Clinical Application

Abstract

Gout is an inflammatory response to deposition of monosodium urate (MSU) crystals in soft tissues and joints, and is the most common form of inflammatory arthritis in adults. Dual-energy computed tomography (CT) is a non-invasive tool for diagnosis, volume quantification of MSU crystals, and monitoring of treatment response. Dual-energy CT is included in the 2015 American College of Rheumatology / European League Against Rheumatism gout classification criteria. Although dual-energy CT has lower sensitivity when restricted to individual crystal-proven gouty joints in non-tophaceous disease, its diagnostic performance is good to excellent for tophaceous gout.