Dual Energy CT: added value in gouty arthritis

Abstract

gouty arthritis is an inflammatory reaction as a result of monosodium urate crystal deposition in synovial fluid and periarticular soft tissue. it is the most common form of inflammatory arthritis with an estimated prevalence of 5 per 1000 in the usa. Clinical diagnosis is difficult and definite diagnosis with positive urate crystal aspiration often is made late in the disease process. dual energy computer tomography (dECt) is a relative new non-invasive imaging modality that is able to distinguish urate crystals from calcium in soft tissue and synovial fluid. in this case report we describe the potential of dECt in gout by clarifying the technical background and present two cases in which dECt confirms the clinical diagnosis and shows the extend of the disease. although more extensive studies should be done to validate dECt in diagnosing gout, the preliminary results in diagnosing gout, determining the extensiveness and monitoring therapy are promising. Key-word: gout.From: 1.

Dual-energy computed tomography has limited diagnostic sensitivity for short-term gout

“…Recent studies showed that imaging techniques may have a potential role in the identification of MSU crystals, including plain radiography, ultrasonography, MRI, conventional computed tomography (CT), and dual-energy computed tomography (DECT). DECT has been reported to have greater sensitivity (78–89%) and specificity (93–100%) than the other techniques for gout diagnosis [ 8 – 11 ]. Thus, DECT is regarded as a critical appliance to diagnose gout patients [ 12 ].…”

Clinical utility of dual-energy CT for gout diagnosis

“…Recently, DECT imaging has been used in the clinical diagnosis and treatment of gout as an emerging new method and has a high value for the assessment of gout [26][27][28], Some literature had described the ability of DECT in detecting MSU. Choi et al [13] noted that DECT can help identify subclinical tophi.…”

Features of urate deposition in patients with gouty arthritis of the foot using dual‐energy computed tomography

“…Recently, dual‐energy CT imaging is an emerging new method used in the clinical treatment of gout, and has a high value for the assessment of gout . In this study, we used dual‐energy CT to analyze the distribution and features of urate crystals around the foot in patients with gout, and simultaneously analyzed the association between features of these deposits and attacks of gouty arthritis.…”