X-ray dark-field radiography for in situ gout diagnosis by means of an ex vivo animal study

Abstract

Gout is the most common form of inflammatory arthritis, caused by the deposition of monosodium urate (MSU) crystals in peripheral joints and tissue. Detection of MSU crystals is essential for definitive diagnosis, however the gold standard is an invasive process which is rarely utilized. In fact, most patients are diagnosed or even misdiagnosed based on manifested clinical signs, as indicated by the unchanged premature mortality among gout patients over the past decade, although effective treatment is now available. An alternative, non-invasive approach for the detection of MSU crystals is X-ray dark-field radiography. In our work, we demonstrate that dark-field X-ray radiography can detect naturally developed gout in animals with high diagnostic sensitivity and specificity based on the in situ measurement of MSU crystals. With the results of this study as a potential basis for further research, we believe that X-ray dark-field radiography has the potential to substantially improve gout diagnostics.

Die Dunkelfeld-Radiografie – ein neuer Weg zur Diagnostik von Gichterkrankungen bei Vögeln und Reptilien?

“…Dazu wurden die Gelenke von an Gicht erkrankten Reptilien und Vögel in einem experimentellen Dunkelfeld-Röntgen-Scanner untersucht und die Ergebnisse auch hinsichtlich einer möglichen Anwendung in der Humanmedizin diskutiert. Teile der Ergebnisse dieser Studie wurden kürzlich mit einem technisch-radiologischen Fokus in einem sich an Medizinphysiker und Radiologen richtenden Journal veröffentlicht 40 . Hier möchten wir den Fokus auf die Diagnose der Gicht in der Exotenmedizin und die Anwendbarkeit der Methode für Tierärzte richten.…”

Improved polarized light microscopic detection of gouty crystals via dissolution with formalin and ethylenediamine tetraacetic acid

“…This problem was initially indicated back in 1986 by Schumacher et al 11 and several other studies proposed for quality control of synovial fluid analyses 12 , 13 . Thus far, various strategies have been developed to improve the sensitivity of MSUM and CPPD detection, including the use of Fv antibodies 14 , fluorescent probes 15 , nanostructured TiO 2 material 16 , X-ray dark field radiography 17 , optical diffraction tomography 18 , lens-free polarized microscopy 19 and dual energy computed tomography 20 . These methods provide high sensitivity for gouty crystal detection, but they require specific reagents and sophisticated instruments.…”