What is the diagnostic value of dual-energy computed tomography in patients with clinical diagnosis of gout?
Open Access
- 29 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Advances in Rheumatology
- Vol. 61 (1), 1-7
- https://doi.org/10.1186/s42358-021-00198-0
Abstract
Objectives: To investigate the frequency of monosodium urate (MSU) crystal deposits on dual-energy computed tomography (DECT) in patients with clinical diagnosis of gout and the factors associated MSU crystal positivity. Methods: This study was conducted in patients with clinical diagnosis of gout who underwent DECT. Clinical features were compared between patients with positive and those with negative DECT results. A logistic regression analysis was performed to determine the factors associated with MSU crystal positivity on DECT. Results: A total of 148 patients with clinical diagnosis of gout were included, and MSU crystal deposition on DECT was observed in 64 patients (43.3%). The patients with positive DECT results were more likely to have renal insufficiency, longer disease duration, and higher serum urate level than those with negative. In the multivariable analysis, first gout attack (odds ratio 0.462; 95% confidence interval 0.229–0.931, p = 0.031) was associated with a less likely MSU crystal deposit-positive DECT result. In the subgroup analysis of patients with first attack, serum urate level > 8 mg/dL was associated with DECT positivity. Conclusion: Of the patients with clinical diagnosis of gout, those with renal insufficiency, longer disease duration, and high serum urate level were more likely to be positive of gout on DECT. First gout attack was associated with less likely to be positive for MSU crystal on DECT. Thus, performing DECT scan in the selected patients who had characteristics that highly probability of DECT positivity could increase positive predictive value.Keywords
Funding Information
- VHS Medical Center Research Grant (VHSMC 20046)
This publication has 31 references indexed in Scilit:
- Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout: a dual energy CT studyAnnals Of The Rheumatic Diseases, 2015
- Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield studyAnnals Of The Rheumatic Diseases, 2014
- Systemic staging for urate crystal deposits with dual-energy CT and ultrasound in patients with suspected goutRheumatology International, 2014
- The distribution of urate deposition within the extremities in gout: a review of 148 dual-energy CT casesSkeletal Radiology, 2013
- Imaging Appearances in GoutArthritis, 2013
- Comorbidities of Gout and Hyperuricemia in the US General Population: NHANES 2007-2008The American Journal of Medicine, 2012
- Clinical Utility of Dual-Energy CT for Evaluation of Tophaceous GoutRadioGraphics, 2011
- Gout. Imaging of gout: findings and utilityArthritis Research & Therapy, 2009
- Diagnostic imaging of gout: comparison of high-resolution US versus conventional X-rayEuropean Radiology, 2007
- Preliminary criteria for the classification of the acute arthritis of primary goutArthritis & Rheumatism, 1977