The distribution of monosodium urate deposition in the extremities and relationship to structural joint damage: dual-energy computed tomography in gout

Congress:

ECR 2020

Poster Number:

C-01957

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Cross-sectional study, Retrospective, Infection, Cancer, Artifacts, Screening, Education, Computer Applications-General, Ultrasound, Digital radiography, CT, Oncology, Musculoskeletal joint, Anatomy, Musculoskeletal

Authors:

L. H. H. Nhi¹, L. H. N. Minh¹, T. M. Thuan², S. Karimzadeh³, E. Mahmoud Mostafa⁴, N. M. Dung¹, L. Van Phuoc⁵, N. T. Huy⁶; ¹Ho Chi Minh/VN, ²Hamilton/CA, ³Sabzevar/IR, ⁴Port Said/EG, ⁵Ho Chi Minh /VN, ⁶Nagasaki/JP

DOI:

10.26044/ecr2020/C-01957

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-01957

Fig. 1: Flow diagram of patient enrollment

Fig. 2: Distribution of tophi volume

Fig. 4: Supplement Figure 1. MSU crystal deposition and periarticular...

Fig. 5: Supplement Figure 3. Sites with largest and smallest MSU crystal deposition...

Purpose

Gout is a common form of inflammatory arthritis which is characterized by elevated serum uric acid and deposition of monosodium urate (MSU) crystals in the joints and soft tissues. In recent years, dual energy computed tomography (DECT) has become a promising, non-invasive procedure for the visualisation, characterisation and quantification of MSU crystals, which aids clinicians in the diagnosis of gout. A few medical centres in Vietnam are capable of performing this technique; hence we conduct this study to examine the diagnostic accuracy of DECT for...

Methods and materials

This cross-sectional retrospective study included patients who were clinically diagnosed with gout and underwent DECT scan from March 2017 and May 2018 at Cho Ray Hospital in Ho Chi Minh City, Vietnam. DECT images were reviewed and damaged regions were anatomically analyzed for the presence of MSU deposition. Data was stratified into 4 major areas: upper limb, lower limb, metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints. Linear regression models were employed to determine the correlation between MSU deposition, serum uric acid concentration and structural damage of...

Results

Twenty-three patients’ DECT results were selected for analysis in this study. All participants were male with mean and standard deviation age were 55.3 and 13.8 years. The mean and standard deviation of disease duration was 6.9 and 5.5 years, and the total subcutaneous tophus appeared in 20 patients (87%). There were 14 (60.9%) patients with gout disease duration longer than 3 years. Serum uric acid level in the population has the mean and standard deviation was 8.3 and 1.7 mg/dl. Furthermore, among these patients, the...

Conclusion

This study reaffirmed DECT as an accurate method for detection of MSU deposits, which aids in the diagnosis of gout. Cost-benefit studies are highly recommended to evaluate the potential of publicly-funded DECT scan in the Vietnamese healthcare system. Besides, findings from this study suggests the potential benefit of urate-lowering therapy for the treatment of structural joint damage.

Personal information and conflict of interest

L. H. H. Nhi; Ho Chi Minh/VN - nothing to disclose L. H. N. Minh; Ho Chi Minh/VN - nothing to disclose T. M. Thuan; Hamilton/CA - nothing to disclose S. Karimzadeh; Sabzevar/IR - nothing to disclose E. Mahmoud Mostafa; Port Said/EG - nothing to disclose N. M. Dung; Ho Chi Minh/VN - nothing to disclose L. V. Phuoc; Ho Chi Minh/VN - nothing to disclose N. T. Huy; Nagasaki/JP - nothing to disclose

References

1. Dalbeth N, Aati O, Kalluru R, et al. Relationship between structural joint damage and urate deposition in gout: a plain radiography and dual-energy CT study. Ann Rheum Dis. 2015;74(6):1030-1036. 2. Choi HK, Burns LC, Shojania K, et al. Dual energy CT in gout: a prospective validation study. Annals of the rheumatic diseases. 2012:annrheumdis-2011-200976. 3. Pascart T, Grandjean A, Norberciak L, et al. Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study. Arthritis research & therapy....