ROLE OF DUAL ENERGY COMPUTED TOMOGRAPHY IMAGING IN GOUT

Abstract

Context: Gout is a crystal induced inammatory arthritis triggered by crystallization of uric acid in joints. The detection of urate crystals is done using polarization light microscopy after synovial uid aspiration which is approach is invasive. Dual energy CT (DECT) is a new imaging modality that is able to identify tophi based on their chemical composition. To evaluate the rol Aims: e of Dual Energy Computed Tomography imaging in gout. A cross sectional observational study, comprising of 30 clinically suspected pati Settings And Design: ents of gout underwent DECT of all peripheral joints (including hand, wrist, elbow, ankle, foot and knee). This Methods And Material: study was conducted on 128 slice SIEMENS Somatom Denition Flash CT scan. A dual energy gout colour coded protocol assessed the chemical composition of the material and an automated volume assessment software, measured the monosodium urate crystal deposition volume. Analysis was Statistical Analysis Used: done using SPSS version 21.0. In lower limb the MTP joint (73.33%) was commonest foll Results: owed by ankle (33%) and knee (26%) with mean crystal volume of 3.51 cm3. In upper limb, MCP and PIP joints (20%) of hand are most commonly affected with mean volume of 0.24cm3. High serum uric acid (>6.4mg/dl) levels showed a positive correlation with MSU crystal deposition in all peripheral joints on DECT. Conclusions: DECT is useful for the diagnosis of gout in symptomatic patients. It can detect MSU crystals volume and urate burden non-invasively.