Dual energy CT in gout: a prospective validation study

Choi, Hyon K.; Burns, Lindsay C; Shojania, Kamran; Koenig, Nicole; Reid, Gregory J.; Abufayyah, Mohammed; Law, Genevieve; Kydd, Alison S; Ouellette, Hugue A.; Nicolaou, Savvas

doi:10.1136/annrheumdis-2011-200976

Cited by 177 publications

(123 citation statements)

References 17 publications

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“…But of the most importance should be to determine the cutoff point for the detection of uric acid crystals by DECT before extensive prospective studies are performed. In a recent published prospective validation study 6 out of 40 (15%) proven gout patients had false negative scans, potentially due to urine lowering therapy (20).…”

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confidence: 99%

Dual Energy CT: added value in gouty arthritis

Spermon

Dijke

2013

Journal of the Belgian Society of Radiology

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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.

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confidence: 99%

Dual Energy CT: added value in gouty arthritis

Spermon

Dijke

2013

Journal of the Belgian Society of Radiology

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“…Также существуют современные неинвазивные инструментальные методи-ки для визуализации кристаллов МУН. К ним относятся УЗИ [17] и DECT [18,19].…”

Section: диагностикаunclassified

Gouty Arthritis – Modern View of the Problem

Мазуров¹,

Петрова²,

Инамова³

et al. 2017

Med. sov.

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“…Dual-energy computed tomography (DECT) can accurately identify monosodium urate deposits in the soft tissues and joints. 40,41 DECT is of value in cases of diagnostic uncertainty or where joint aspiration is difficult. Screening is not recommended in asymptomatic HU as the risk benefit of treating these patients is unknown.…”

Section: Role Of Imaging In Patients With Asymptomatic Hyperuricaemiamentioning

confidence: 99%

Update on hyperuricaemia and gout with evidence based management guidelines

Mody

2015

South African Family Practice

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Gout is now the leading cause of inflammatory arthritis, affecting 1-2% of the population. The metabolic syndrome, cardiovascular risk factors, cardiovascular events and mortality are more common with gout. However, the role of uric acid as an independent risk factor is inconclusive. The identification of urate transporters has improved our understanding of urate homeostasis and identified targets for the development of newer drugs. Experience with ultrasound and dual energy computed tomography led to the detection of urate crystals in patients with asymptomatic hyperuricaemia. Several evidence-based management guidelines are now available. The dietary and lifestyle recommendations focus on general health and management of comorbidities. A low dose colchicine regimen is effective and better tolerated than the traditional use of higher doses in acute gout. Alternative measures for acute gout include non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. Allopurinol is the most widely used initial therapy; treatment is started with 100 mg or less per day, and titrated upwards to achieve a target level of 0.36 mmol/l (in patients with tophi, a lower target of 0.30 mmol/l is recommended). A new non-purine more potent xanthine oxidase inhibitor, febuxostat, is available (currently not registered in South Africa). Probenecid is the most widely used uricosuric agent. Prophylactic therapy with colchicine, NSAIDs or corticosteroids is used when urate lowering therapy is initiated. Although the cause of gout is known and effective treatment is available, gout is poorly managed worldwide with failure to achieve the target urate level.

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Dual energy CT in gout: a prospective validation study

Abstract: These prospective data indicate high reproducibility of DECT urate volume measures. The specificity was high, but sensitivity was more moderate, potentially due to frequent ULT use in our patients.

Cited by 177 publications

References 17 publications

Dual Energy CT: added value in gouty arthritis

Dual Energy CT: added value in gouty arthritis

Gouty Arthritis – Modern View of the Problem

Update on hyperuricaemia and gout with evidence based management guidelines

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