scholarly journals Urate crystal deposition in hyperuricemic children: a dual energy computed tomography study

2021 ◽  
Vol 17 (1) ◽  
pp. 100-105
Author(s):  
Qianqian Ying ◽  
Jiapei Wang ◽  
Yunyan Li ◽  
Nan Sun ◽  
Yazhen Di ◽  
...  
Keyword(s):  
Rapid Onset ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Coastal Regions ◽  
Intense Pain ◽  
Asymptomatic Group ◽  
Crystal Deposition ◽  
History Of ◽  
Urate Crystal ◽  
Joint Group

IntroductionThe incidence of hyperuricemia (HUA) at younger ages is increasing along the coastal regions of China. This study aimed to compare the frequency of dual energy CT (DECT) urate crystal deposition between symptomatic hyperuricemic children and asymptomatic hyperuricemic children.Material and methodsFifty-six hyperuricemic children were divided into a Joint Group (n = 33) and an Asymptomatic Group (n = 23) according to whether they had a history of arthritis symptoms, which includes rapid onset monoarthritis with intense pain and swelling. We analyzed DECT scans of their feet from the Joint Group and the Asymptomatic Group and compared their clinical features.ResultsDECT urate deposits were observed in 28/33 (84.8%) children with symptomatic HUA and 14/23 (60.9%) with asymptomatic HUA. We found 60 areas of urate deposition in the Joint Group; DECT urate crystal deposition was most frequently observed in the first metatarsophalangeal (MTP) joint (30.0%), ankle joint (15.0%), and calcaneus (13.3%). 39 urate deposits were found in the Asymptomatic Group; DECT urate crystal deposition was most frequently observed in the calcaneus (25.6%), the first MTP joint (17.9%), and the first phalanx (15.4%).ConclusionsUrate deposition can occur in children with HUA, and these deposits occur more frequently in hyperuricemic children with a history of arthritis symptoms. Also, the urate deposition in the first MTP joint and calcaneus was more prevalent than in other joints. It is important to give more attention to hyperuricemic children.

Vascular monosodium urate crystal deposition in gout: a dual‐energy CT and microscopy study of cadaveric donors

2022 ◽  
Author(s):  
Nicola Dalbeth ◽  
Mariam Alhilali ◽  
Peter Riordan ◽  
Ravi Narang ◽  
Ashika Chhana ◽  
...  
Keyword(s):  
Microscopy Study ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Monosodium Urate ◽  
Crystal Deposition ◽  
Urate Crystal ◽  
Cadaveric Donors

scholarly journals Presence of monosodium urate crystal deposition by dual-energy CT in patients with gout treated with allopurinol

2017 ◽  
Vol 77 (3) ◽  
pp. 364-370 ◽  
Author(s):  
Nicola Dalbeth ◽  
Savvas Nicolaou ◽  
Scott Baumgartner ◽  
Jia Hu ◽  
Maple Fung ◽  
...  
Keyword(s):  
Severe Disease ◽  
Serum Urate ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Monosodium Urate ◽  
Crystal Deposition ◽  
Patient Global Impression ◽  
The Usa ◽  
Urate Crystal ◽  
Crystal Volume

ObjectiveDual-energy CT (DECT) detects and quantifies monosodium urate (MSU) crystal deposition with high precision. This DECT study assessed crystal deposition in patients with gout treated with stable-dose allopurinol, and investigated potential clinical determinants for crystal deposition.MethodsPatients with gout treated with allopurinol ≥300 mg daily for at least 3 months were prospectively recruited from the USA and New Zealand, using monitored enrolment to include approximately 25% patients with palpable tophi and approximately 50% with serum urate (sUA) levels <6.0 mg/dL (<357µmol/L). MSU crystal deposition was measured in the hands/wrists, feet/ankles/Achilles and knees bilaterally. The presence and total volume of crystals were assessed by DECT and analysed according to sUA levels and gout characteristics.ResultsAmong 152 patients receiving allopurinol ≥300 mg/day for 5.1 years on average, 69.1% had crystal deposition on DECT, with a median total crystal volume of 0.16 cm3 (range: 0.01–19.53 cm3). The prevalence of crystal deposition ranged from 46.9% among patients with sUA <6.0 mg/dL and no palpable tophi to 90.0% among those with sUA ≥6.0 mg/dL and tophi. Total volume of crystal deposition was positively associated with sUA ≥6.0 mg/dL, gout flares within the past 3 months and tophi. Total volume of crystal deposition correlated positively with Patient Global Impression of Disease Activity scores.ConclusionA substantial proportion of patients without palpable tophi have MSU crystal deposition, despite receiving allopurinol doses ≥300 mg/day for a considerable duration. Patients with higher sUA and clinical features of severe disease have a higher frequency and greater volume of MSU crystal deposition.

Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout: a dual energy CT study

2015 ◽  
Vol 74 (5) ◽  
pp. 908-911 ◽  
Author(s):  
Nicola Dalbeth ◽  
Meaghan E House ◽  
Opetaia Aati ◽  
Paul Tan ◽  
Christopher Franklin ◽  
...  
Keyword(s):  
Dual Energy ◽  
Dual Energy Ct ◽  
Crystal Deposition ◽  
Urate Crystal

scholarly journals AB0934 DUAL-ENERGY COMPUTED TOMOGRAPHY IN GOUT PATIENTS: IS IT USEFUL IN GENERAL PRACTICE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1767.2-1767 ◽  
Author(s):  
Y. Sherman ◽  
P. Lipsky ◽  
M. Bramwit ◽  
N. Schlesinger
Keyword(s):  
General Practice ◽  
Elevated Serum ◽  
High Sensitivity ◽  
Serum Urate ◽  
Calcium Pyrophosphate ◽  
Dual Energy ◽  
University Hospital ◽  
Dual Energy Ct ◽  
Crystal Deposition ◽  
History Of

Background:Dual-Energy CT (DECT) has high sensitivity and specificity for detecting monosodium urate (MSU) crystal deposition. Although widely used in research, few studies have evaluated the usefulness of DECT in clinical practice.Objectives:To evaluate the use of DECT in a clinical setting and determine its utilityMethods:We retrospectively evaluated the records of all patients referred for DECT scans over a 6.5-year period. Patient charts were reviewed for clinical features.Results:113 patients (17.5/yr) received DECT evaluation at a university hospital over the study period (234 scans). All were referred by rheumatologists. Medical records were available for 69 patients (134 scans), including 44 males and 25 females (mean age 62 (SD, 12.9, range: 34-85 yrs). Mean duration of gout was 6.7 (SD, 8.1) yrs. DECT was ordered to evaluate known gout (36/69, 52.1%), suspected gout (32/69, 46.4%), and suspected calcium pyrophosphate (CPP) disease (1/69, 1.4%). 32/69 (46.4%) of patients were on urate-lowering therapy.61% (42/69) had MSU crystal and none had CPP deposition. Mean MSU volume was 1.6cc (SD, 5.2cc; range: 0.01-35 cc.) The joints imaged were feet/ankles (80/134, 60%) and hands/wrists (53/134, 40%). 23/33 (69.7%) patients with DECT positivity had elevated serum urate (SU) levels >6mg/dL; however, elevated SU was not significantly associated with DECT positivity (odds ratio (OR) 1.9, 95% CI:0.59-5.95, p=0.28).For patients with positive scans, mean gout duration from first known flare was 9.5 (SD, 8.8) yrs.Among patients who had scans completed within 1 yr of the first known gout flare, 1/10 were positive (10%); 4/16 within 2 yrs (25%); and 8/21 within 3 yrs (29.6%).Of patients with positive DECT scans, 24/42 (57%) had symmetric distribution of MSU crystal deposition: 10/24 (42%) hands and 14/24 (58%) feet; with gout duration of 7.9 (SD, 8.0) yrs.Conclusion:DECT was infrequently utilized and only by rheumatologists. Only 60 % of patients referred for DECT scanning because of known or suspected gout had MSU deposition. DECT was uncommonly positive in patients with a 1-3 yr history of gout. When positive, the MSU crystal deposition was symmetrical in most gout patients. DECT scans, while important in furthering our understanding of gout biology, are not routinely used in general practice and often do not provide important decision support information. Establishment of practice guidelines might be important in developing more appropriate utilization of DECT.Disclosure of Interests:Yekaterina Sherman: None declared, Peter Lipsky Consultant of: Horizon Therapeutics, Mark Bramwit: None declared, Naomi Schlesinger Grant/research support from: Pfizer, AMGEN, Consultant of: Novartis, Horizon Pharma, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, Speakers bureau: Takeda, Horizon

Systemic staging for urate crystal deposits with dual-energy CT and ultrasound in patients with suspected gout

2014 ◽  
Vol 34 (6) ◽  
pp. 763-771 ◽  
Author(s):  
Alexander Huppertz ◽  
Kay-Geert A. Hermann ◽  
Torsten Diekhoff ◽  
Moritz Wagner ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Dual Energy ◽  
Dual Energy Ct ◽  
Urate Crystal
Sign in / Sign up

Export Citation Format

Share Document