Dual-energy computed tomography as a diagnostic tool for gout during intercritical periods
| Autor: | Gideon Nesher, Naama Bogot, Gabriel S. Breuer |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Gout Arthritis Asymptomatic Gout Suppressants 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Rheumatology Predictive Value of Tests Positive predicative value medicine Humans Synovial fluid Aged Retrospective Studies 030203 arthritis & rheumatology business.industry Retrospective cohort study Middle Aged medicine.disease Uric Acid Treatment Outcome chemistry Predictive value of tests Asymptomatic Diseases Radiographic Image Interpretation Computer-Assisted Uric acid Female Joints Radiology medicine.symptom Tomography X-Ray Computed Nuclear medicine business Biomarkers |
| Zdroj: | International Journal of Rheumatic Diseases. 19:1337-1341 |
| ISSN: | 1756-1841 |
| Popis: | Aim The aim of this study is to evaluate the diagnostic yield of dual-energy computed tomography (DECT) in detection of uric acid accumulation in joints or periarticular structures in patients suspected of having gout, in their intercritical period. Methods Patients with a history of recurrent, short-lived mono- or oligo-arthralgia or arthritis, referred to the rheumatology clinic for diagnosis of their condition, were included in this retrospective evaluation. Results DECT confirmed the diagnosis of gout in 30 of 50 patients (60%). A positive DECT was present in 12 of 16 cases (75%) with serum uric acid > 8.5 mg/dL, compared to seven of 13 cases (54%) and two of five cases (40%) with levels of 6.1-8.5 mg/dL and ≤ 6 mg/dL, respectively. The diagnostic impact of screening hands and feet were highest (78% and 56%, respectively). Follow-up data were available for 24 of the 30 patients with urate deposits identified by DECT. Twenty-one were treated with urate-lowering agents, all responded with lowering of serum uric acid and cessation of flares. Follow-up data were available for 16 of the 20 patients with no urate deposits identified by DECT. Gout was diagnosed in two of them by synovial fluid examination during subsequent flares. Both positive and negative predictive values of DECT for diagnosing gout in this patient population were 87%. Following DECT, treatment regimen was modified to gout-specific therapy in 52% of the patients. Discussion The ability to make a definite diagnosis of gout by DECT imaging in a substantial number of asymptomatic patients in the intercritical period should help in treatment decision-making and improve patient adherence to long-term urate-lowering therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
| Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |