Abstract
ObjectivesTo assess the distribution of bone erosions and two erosion scores in the feet of patients with gout and analyze the association between erosion scores and monosodium urate (MSU) crystal deposition using dual-energy computed tomography (DECT).Materials and methodsWe included all patients who underwent DECT of both feet between 2016 and 2019 in our radiology department, with positive detection of MSU deposits. Data on sex, age, treatment, serum urate, and DECT urate volumes were obtained. CT images were analyzed to score bone erosions in 31 sites per foot by using the semi-quantitative method based on the Rheumatoid Arthritis MRI Scoring (RAMRIS) system and the Dalbeth-simplified score. Reproducibility for the two scores was calculated with intraclass correlation coefficients (ICCs). Correlations between clinical features, erosion scores and urate crystal volume were analyzed by the Spearman correlation coefficient (r).ResultsWe studied 61 patients (mean age 62.0 years); 3,751 bones were scored. The first metatarsophalangeal joint and the midfoot were the most involved in terms of frequency and severity of bone erosions. The distribution of bone erosions was not asymmetrical. The intra- and inter-observer reproducibility was similar for the RAMRIS and Dalbeth-simplified scores (ICC 0.93 vs 0.94 and 0.96 vs 0.90). DECT urate volume was significantly correlated with each of the two erosion scores (r = 0.58–0.63, p < 0.001). There was a high correlation between the two scores (r = 0.96, p < 0.001).ConclusionsDECT demonstrates that foot erosions are not asymmetric in distribution and predominate at the first ray and midfoot. The two erosion scores are significantly correlated with DECT urate volume. An almost perfect correlation between the RAMRIS and Dalbeth-simplified scores is observed.
Highlights
Gout is the most prevalent inflammatory arthritis worldwide [1]
The intra- and inter-observer reproducibility was similar for the Rheumatoid Arthritis MRI Scoring (RAMRIS) and Dalbeth-simplified scores (ICC 0.93 vs 0.94 and 0.96 vs 0.90)
Dual-energy computed tomography (DECT) demonstrates that foot erosions are not asymmetric in distribution and predominate at the first ray and midfoot
Summary
Gout is the most prevalent inflammatory arthritis worldwide [1] It is a crystal deposition disease due to monosodium urate (MSU) crystals. Dual-energy computed tomography (DECT) has the remarkable ability to non-invasively detect MSU crystal deposits, with high sensitivity and specificity [2,3,4,5,6,7,8,9,10]. The combination of reconstructed images from raw data of each acquisition allows for detecting MSU crystal deposits and provides an automatic quantification of the volume of these deposits. DECT is mainly used to detect tophi and for quantification, but its ability to provide high resolution images has poorly been exploited. Few studies [12,13,14] used DECT-based bone images reconstruction for analysis of gouty erosions
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
