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What Has Dual Energy CT Taught Us About Gout?

  • Crystal Arthritis (M Pillinger and M Toprover, Section Editors)
  • Published:
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Abstract

Purpose of the Review

Dual energy computed tomography (DECT) scan has emerged as a useful diagnostic tool in the diagnosis of gout over recent years. Here, we review the role of DECT in the context of typical and atypical gout, including its role in identifying extra-articular monosodium urate (MSU) deposition.

Recent Findings

DECT has been found to be more accurate than ultrasound in detecting extra-articular MSU deposition in soft tissue. It has the ability to identify axial MSU deposition in gout patients with non-specific back pain. For individuals with no other clear etiology, this potentially implicates MSU as the cause of the pain. DECT also has the ability to detect vascular MSU deposition. This correlates with high coronary calcium scores and elevated Framingham cardiovascular risk.

Summary

DECT continues to aid our understanding of articular and extra-articular MSU deposition, including the role of vascular MSU deposition on cardiovascular health. Not only does it allow quantification of urate burden but it can also potentially avoid invasive diagnostic procedures. The limitations and advantages of DECT are further explored in this article.

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Authors and Affiliations

  1. Division of Rheumatology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA

    Ira Khanna & Yousaf Ali

  2. Department of Internal Medicine, Icahn School of Medicine, Mount Sinai West, New York, NY, USA

    Rebecca Pietro

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Correspondence to Ira Khanna.

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The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. Author names: Ira Khanna, Rebecca Pietro, Yousaf Ali.

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“As a former football player and wrestler who had had three knee operations, Scott thought he knew pain. Then he had his first gout attack.” [1]. Excerpt from the Arthritis Foundation blog highlighting the excruciating experience that is gout.

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Khanna, I., Pietro, R. & Ali, Y. What Has Dual Energy CT Taught Us About Gout?. Curr Rheumatol Rep 23, 71 (2021). https://doi.org/10.1007/s11926-021-01035-5

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