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Gout of ankle and foot: DECT versus US for crystal detection

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Abstract

Objective

To compare dual-energy computed tomography (DECT) and ultrasound (US) in detecting monosodium urate (MSU) crystals in the ankle and foot in patients with acute gouty arthritis.

Methods

Bilateral ankle and foot were examined by DECT and US and the differences between the findings were compared.

Results

A total of 50 patients underwent DECT and US examinations. At the patient level, the overall positivity of crystal deposition detected by DECT was higher than that by US (92% vs 68%, P = 0.005). The agreement of detecting crystal deposition between DECT and US was not very strong (К = 0.44, P = 0.003). At different joint/area levels, there were significant differences between the two examinations in the area of the dorsum (36% vs 12%, P = 0.009) and metatarsal bone (34% vs 12%, P = 0.017), but the sensitivity of DECT and US was similar in the first metatarsophalangeal joint (MTP) and ankle areas (P>0.05). Agreement between the two examinations in the ankle and first MTP was very strong (К = 0.86, P < 0.001; К = 0.79, P < 0.001, respectively). However, agreement between the two examinations in other joints/areas was poor.

Conclusion

These findings indicated that DECT should be the first choice for acute gouty arthritis in patients with ankle and foot involvement.

Key Points

• There is little data regarding DECT and US in detecting MSU crystals in the ankle and foot in patients with acute gouty arthritis.

• The overall positivity of crystal deposition detected by DECT was higher than that by US, but the sensitivity of DECT and US was similar in the first metatarsophalangeal joint (MTP) and ankle areas.

• Agreement between the two examinations in the ankle and first MTP was very strong; however, agreement between the two examinations in other joints/areas was poor.

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Funding

This study was partly supported by the grants from the National Science Foundation of Zhejiang (LY19H100002) and 2019 Jiaxing Key Supporting Discipline of Medicine Rheumatology and Autoimmunology (2019-ZC-03).

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Authors and Affiliations

  1. Department of Rheumatology and Nephrology, Qianjiang Central Hospital, Qianjiang Clinical Medical College of Yangtze University, Qianjiang, 433100, Hubei, China

    Zhengping Zou

  2. Department of Rheumatology, Affiliated Hospital of Jiaxing University, The First Hospital of Jiaxing, Jiaxing, 314000, Zhejiang, China

    Mingfeng Yang, Yiwen Wang & Bin Zhang

Authors
  1. Zhengping Zou
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  2. Mingfeng Yang
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  3. Yiwen Wang
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  4. Bin Zhang
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Corresponding author

Correspondence to Bin Zhang.

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The study protocol was approved by the First Affiliated Hospital of Jiaxing University Ethics Committee. Written informed consent was obtained from each patient. The study was conducted in accordance with the principles of the Declaration of Helsinki.

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Zou, Z., Yang, M., Wang, Y. et al. Gout of ankle and foot: DECT versus US for crystal detection. Clin Rheumatol 40, 1533–1537 (2021). https://doi.org/10.1007/s10067-020-05378-9

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  • DOI: https://doi.org/10.1007/s10067-020-05378-9

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