title: Comparison Between Dual-Energy Computed Tomography and Ultrasound in the Diagnosis of Gout of Various Joints.
abstract: OBJECTIVE
  Dual-energy computed tomography (DECT) and ultrasound are both used to assess gouty arthritis. The present study was designed to compare the diagnostic accuracy of DECT and ultrasound in detecting monosodium urate (MSU) crystal deposition in various joints.
  
  
  METHODS
  This study enrolled 40 patients diagnosed with acute gouty arthritis. All affected and contralateral joints were scanned (128 in total) using both DECT and ultrasound to determine the MSU deposition in upper limbs (wrist and elbow) and lower limbs (the first metatarsophalangeal joints, ankles, and knee). The MSU crystal accumulation detected by each method was compared for various joints.
  
  
  RESULTS
  The 128 scanned joints included 52 of the upper limbs and 76 of the lower limbs. For the upper limbs, the percentage of MSU crystal accumulation detected by DECT (22/52, 42.3%) was significantly higher than that by ultrasound (10/52, 19.2%; P = .0027). The detection rates of the two methods for the lower limbs were similar (P = .3173).
  
  
  CONCLUSIONS
  For detection of MSU crystal deposition in the upper limb joints, DECT was superior to ultrasound, whereas there was no difference between the two methods for the lower limbs. Therefore, ultrasound can be used for primary screening, and DECT afterward. Although the modalities are similar in making the initial diagnosis, DECT is far superior at displaying the anatomic extent of the disease.
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Huaxiang
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Wenjia
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Lv
authors.initials: L
authors.lastname: Ye
authors.affiliation: Department of Rheumatology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Wenwen
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Nephrology, Second Affiliated Hospital Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, China. Electronic address: grayll1059@163.com.
authors.forename: Jianqing
authors.initials: J
authors.lastname: Wang
mesh_terms: D000368:Aged; D015210:Arthritis, Gouty / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014527:Uric Acid / Q000032:analysis
chemical_list: D014527:Uric Acid
keywords: Gout; dual-energy CT; gouty arthritis; ultrasound