- “ A diagnosis of gout is generally straightforward and is usually reached by evaluating clinical, laboratory, and radiologic findings. By using specific attenuation characteristics to differentiate urate crystals from calcium, dual energy CT may be helpful when the diagnosis is unclear, as in cases of atypical clinical manifestations, discordant levels of serum urate, or in differentiating an acute attack from chronic changes.”
Clinical Utility of Dual-Energy CT for Evaluation of Tophaceous Gout
Desai MA et al.
RadioGraphics 2011;31:1365-1375 - “ Dual-energy CT may be used to differentiate uric acid from calcium in musculoskeletal tissue, allowing gouty urate crystals to be distinguished from bone or dystrophic calcifications.”
Clinical Utility of Dual-Energy CT for Evaluation of Tophaceous Gout
Desai MA et al.
RadioGraphics 2011;31:1365-1375 - “ In the most common clinical manifestations of acute gout, rapid onset of a painful monoarthopathy occurs in the distal appendicular skeleton, often in the first metatarsophalangeal joint, in a middle aged man or postmenopausal woman. Atypical clinical manifestations also are seen with increased frequency in certain segments of the population, including the elderly and patients who underwent organ transplantation and those with a tumor, prostheses and genetic mutations.”
Clinical Utility of Dual-Energy CT for Evaluation of Tophaceous Gout
Desai MA et al.
RadioGraphics 2011;31:1365-1375 - “ Unlike other modalities, dual energy CT is inherently able to distinguish urate crystal deposits from surrounding structures, and it provides sensitive and specific volumetric quantification with no user variability.”
Clinical Utility of Dual-Energy CT for Evaluation of Tophaceous Gout
Desai MA et al.
RadioGraphics 2011;31:1365-1375 - Mimics of Gout: Differential Diagnosis
- Septic arthritis
- Osteomyelitis
- Pseudogout (calcium pyrophosphate deposition disease)
- Rheumatoid arthritis
- Malignancy (lytic lesion)
- Tendinopathy - Role of Dual Energy CT in the Diagnosis of Gout as a Problem Solver
- Unusual clinical presentations
- Discordant uric acid levels
- Acute vs chronic gout
- Subclinical disease
- Mimics of gout vs gout
- Quantification of gout for therapy monitoring - DE Protocol
Single acquisition at both 80 and 140 kVp
Color coded mapping with Green being positive for urate crystals
3D mapping useful for defining extent of disease
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