The utility of dual energy computed tomography in the management of axial gout: case reports and literature review

Wang, Jeremy X.; Ng, Beverly; Bak, Haesung; Spencer, David; Manolios, Nicholas; Wong, Peter

doi:10.1186/s41927-020-00119-6

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…Recently, DECT has been increasingly used to identify MSU deposits in the appendicular skeleton as a highly sensitive and specific radiologic tool (11). The diagnostic use of DECT in axial gout has been rarely reported (28,29). In our illustrative case study with histological confirmation, the identification of MSU crystals within the foci of erosive lesions on DECT strongly suggested axial gout.…”

Section: Discussionmentioning

confidence: 65%

The Frequency of Axial Deposition in Korean Patients With Gout at a Tertiary Spine Center

2020

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Objectives: This study aimed to describe the frequency of axial deposition (axial gout) and determine the associated factors in patients with gout who presented to a spine clinic in Korea. Methods: We enrolled 95 Korean patients who visited our spine center from March 2012 to February 2016 and who had been previously diagnosed with gout and had available computed tomography (CT) images of the vertebral columns. Axial gout was defined as the presence of erosions or tophi in the vertebral endplate or facet joint. The clinical and laboratory data of these patients were retrieved from medical records. Results: Out of 95 patients, 15 [15.8%; 95% confidence interval (CI), 9.4-25.0%] had a conventional CT evidence suggestive of axial gout. In these 15 patients, 12 (80%) had lumbar spine involvement (95% CI, 51.4-94.7%). Fifteen patients had erosions of the vertebral column, and two presented with tophi that exhibited erosive changes of the facet joints. The presence of axial gout was not associated with the patients' age, duration of gout, laboratory findings, inflammatory back pain symptoms, identification of monosodium urate crystals in the peripheral joints, current use of urate-lowering drugs, hypertension, and end-stage renal disease; however, there was a significant association with the presence of diabetes (P = 0.008). Conclusions: The frequency of axial deposition in Korean patients with gout and spinal symptoms was 15.8%, with the lumbar region being the most commonly involved section of the spine. In addition, diabetes was associated with evidence of axial gout on imaging.

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Section: Discussionmentioning

confidence: 65%

The Frequency of Axial Deposition in Korean Patients With Gout at a Tertiary Spine Center

2020

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“…Dual energy computed tomography (DECT) can provide additional information respect to conventional CT in the diagnosis of gout in spinal structures, with a sensitivity between 78 and 100% and a specificity between 89–100% in detecting monosodium urate deposition [ 41 ].…”

Section: Inflammatory Disorders Of the Spinementioning

confidence: 99%

Differentiation between infectious spondylodiscitis versus inflammatory or degenerative spinal changes: How can magnetic resonance imaging help the clinician?

et al. 2021

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Spondylodiscitis is a complex disease whose diagnosis and management are still challenging. The differentiation between infectious and non-infectious aetiology is mandatory to avoid delays in the treatment of life-threatening infectious conditions. Imaging methods, in particular magnetic resonance imaging (MRI), play a key role in differential diagnosis. MRI provides detailed anatomical information, especially regarding the epidural space and spinal cord, and may allow differential diagnosis by assessing the characteristics of certain infectious and inflammatory/degenerative lesions. In this article, we provide an overview of the radiological characteristics and differentiating features of non-infectious inflammatory spinal disorders and infectious spondylodiscitis, focussing on MRI results and presenting relevant clinical and pathological features that help early diagnosis.

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“…8 Although DECT has been used more commonly for detection of urate crystals in peripheral joints, there have been only a few case reports of its use for spinal gout. 9 Given the variable and nonspecific appearance of spinal gout, CT and contrast-enhanced MRI of the spine are complementary and both may add value in making the diagnosis.…”

Section: Imaging Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Spinal gout: Imaging and clinical features

Mogensen

DeConde

Sarıkaya

2021

PM&R

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The utility of dual energy computed tomography in the management of axial gout: case reports and literature review

Cited by 11 publications

References 15 publications

The Frequency of Axial Deposition in Korean Patients With Gout at a Tertiary Spine Center

The Frequency of Axial Deposition in Korean Patients With Gout at a Tertiary Spine Center

Differentiation between infectious spondylodiscitis versus inflammatory or degenerative spinal changes: How can magnetic resonance imaging help the clinician?

Spinal gout: Imaging and clinical features

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