To review the clinical indications for dual energy in the diagnosis and characterisation or musculoskeletal conditions.

Dual energy CT (DECT) technology over the past two decades has shown diagnostic advantages due to its ability to extract tissue composition information. The ability of DECT to provide atomic number based information allows for a wider number of clinical applications in the musculoskeletal system. Different energy photons are absorbed to different extents by tissues with a relatively high atomic number (such as calcium and iodine), however tissues with a low average atomic number (such as fluid, fat, soft tissue) are absorbed to a similar...

Gout Gout is an inflammatory condition characterised by monosodium urate crystal deposition in joints and soft tissues. It has a predilection for certain joints (eg metatarsophalangeal and metacarpophalangeal joints, ankle, shoulder) and soft tissues (eg patellar and quadriceps tendons, olecranon bursa) (2) and is more common in males, certain ethnic groups such as Maori and Pacific Islander, renal disease and alcohol consumption. The diagnosis of gout is classically by joint aspiration and polarised microscopy assessment for the presence of monosodium urate crystals. This has the...

Dual energy CT allows greater tissue characterisation and has a wide range of applications in musculoskeletal conditions. Continued advancements in CT scanner and detector technology have allowed many material decomposition algorithms to be developed. From improvements in image artefact, to demonstration of bone marrow edema, through to confirming and excluding the presence of particular materials such as monosodium urate in gout, DECT technology continues to prove its usefulness.

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