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Comparative Study
. 2020 May;39(5):1649-1653.
doi: 10.1007/s10067-020-05014-6. Epub 2020 Mar 10.

Diagnostic value of ultrasound versus dual-energy computed tomography in patients with different stages of acute gouty arthritis

Bin Zhang  1 , Mingfeng Yang  1 , Hongzhi Wang  2
Affiliations
Comparative Study

Diagnostic value of ultrasound versus dual-energy computed tomography in patients with different stages of acute gouty arthritis

Bin Zhang et al. Clin Rheumatol. 2020 May.

Abstract

Objective: Previous studies of the diagnostic accuracy of ultrasound (US) and dual-energy computed tomography (DECT) in patients with gout have reported different results. The aim of this study is to compare the diagnostic value of US and DECT in patients with different stages of acute gouty arthritis.

Methods: Based on the presence of monosodium urate (MSU) crystals in the synovial fluid, patients (n = 37) were divided into three groups according to gout duration: early stage (within 1 year, n = 15), middle stage (1 to 3 years, n = 12), and late stage (more than 3 years, n = 10). All the affected joints were examined by US and DECT.

Results: In the early-stage group, the sensitivity of US was significantly higher than DECT in identifying MSU deposition (66.7% vs 26.6%, p < 0.05), while in the middle- and late-stage groups, the sensitivity of US and DECT was similar. In the early-stage group, the US results in nine joints were positive (four with double contour sign, four with snowstorm sign, and one with both double contour sign and snowstorm sign), while DECT did not show any urate crystal deposits.

Conclusion: These findings indicate that US should be the first choice for acute gouty arthritis, especially in patients with early-stage disease.Key Points• Previous studies have compared DECT with US to evaluate the reliability of each method in diagnosing gout but have reported different results, which may be partly due to different gout duration.• In our study, the sensitivity of US was significantly higher than DECT in identifying MSU deposition in the early-stage group, while in the middle- and late-stage groups, the sensitivity of US and DECT was similar.• US should be the first choice for the diagnosis of acute gouty arthritis, especially in patients with early-stage disease.

Keywords: Acute gouty arthritis; Dual-energy computed tomography (DECT); Gout duration; Monosodium urate (MSU) crystals; Ultrasound (US).

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References

    1. Brook RA, Forsythe A, Smeeding JE, Lawrence Edwards N (2010) Chronic gout: epidemiology, disease progression, treatment and disease burden. Curr Med Res Opin 26:2813–2821 - DOI
    1. Zhang W, Doherty M, Pascual E, Bardin T, Barskova V, Conaghan P, Gerster J, Jacobs J, Leeb B, Lioté F, McCarthy G, Netter P, Nuki G, Perez-Ruiz F, Pignone A, Pimentão J, Punzi L, Roddy E, Uhlig T, Zimmermann-Gòrska I, EULAR Standing Committee for International Clinical Studies Including Therapeutics (2006) EULAR evidence based recommendations for gout. part I: diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 65:1301–1311 - DOI
    1. Gamala M, Jacobs JWG, Linn-Rasker SF et al (2019) The performance of dual-energy CT in the classification criteria of gout: a prospective study in subjects with unclassified arthritis. Rheumatology (Oxford):2019
    1. Schueller-Weidekamm C, Schueller G, Aringer M, Weber M, Kainberger F (2007) Impact of sonography in gouty arthritis: comparison with conventional radiography, clinical examination, and laboratory findings. Eur J Radiol 62:437–443 - DOI
    1. Choi HK, Burns LC, Shojania K, Koenig N, Reid G, Abufayyah M, Law G, Kydd AS, Ouellette H, Nicolaou S (2012) Dual energy CT in gout: a prospective validation study. Ann Rheum Dis 71:1466–1471 - DOI

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