Dmitrij Kravchenko1, Pantelis Karakostas2, Daniel Kuetting3, Carsten Meyer3, Peter Brossart2, Charlotte Behning4, Valentin S Schäfer2. 1. Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. dmitrij.kravchenko@live.ca. 2. Clinic of Internal Medicine III, Hematology, Oncology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany. 3. Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. 4. Institute for Medical Biometrics, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany.
Abstract
OBJECTIVES: To analyse the diagnostic impact of dual energy computed tomography (DECT) in acute gout flares and acute calcium pyrophosphate (CPP) crystal arthritis when compared to the gold standard of arthrocentesis with compensated polarised light microscopy. Microscopy results were also compared to musculoskeletal ultrasound (MUS), conventional radiographs, and the suspected clinical diagnosis (SCD). METHODS: Thirty-six patients with a suspected gout flare (n = 24) or acute CPP crystal arthritis (n = 11, n = 1 suffered from neither) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed DECT images for signs of monosodium urate crystals or calcium pyrophosphate deposition. RESULTS: Sensitivity of DECT for gout was 63% (95% CI 0.41-0.81) with a specificity of 92% (0.41-0.81) while sensitivity and specificity for acute CPP arthritis were 55% (0.23-0.83) and 92% (0.74-0.99), respectively. MUS had the highest sensitivity of all imaging modalities with 92% (0.73-0.99) and a specificity of 83% (0.52-0.98) for gout, while sensitivity and specificity for acute CPP crystal arthritis were 91% (0.59-1.00) and 92% (0.74-0.99), respectively. CONCLUSION: DECT is an adequate non-invasive diagnostic tool for acute gout flares but might have a lower sensitivity than described by previous studies. Both MUS and SCD had higher sensitivities than DECT for acute gout flares and acute CPP crystal arthritis.
OBJECTIVES: To analyse the diagnostic impact of dual energy computed tomography (DECT) in acute gout flares and acute calcium pyrophosphate (CPP) crystal arthritis when compared to the gold standard of arthrocentesis with compensated polarised light microscopy. Microscopy results were also compared to musculoskeletal ultrasound (MUS), conventional radiographs, and the suspected clinical diagnosis (SCD). METHODS: Thirty-six patients with a suspected gout flare (n = 24) or acute CPP crystal arthritis (n = 11, n = 1 suffered from neither) who received a DECT and underwent arthrocentesis were included. Two independent readers assessed DECT images for signs of monosodium urate crystals or calcium pyrophosphate deposition. RESULTS: Sensitivity of DECT for gout was 63% (95% CI 0.41-0.81) with a specificity of 92% (0.41-0.81) while sensitivity and specificity for acute CPP arthritis were 55% (0.23-0.83) and 92% (0.74-0.99), respectively. MUS had the highest sensitivity of all imaging modalities with 92% (0.73-0.99) and a specificity of 83% (0.52-0.98) for gout, while sensitivity and specificity for acute CPP crystal arthritis were 91% (0.59-1.00) and 92% (0.74-0.99), respectively. CONCLUSION: DECT is an adequate non-invasive diagnostic tool for acute gout flares but might have a lower sensitivity than described by previous studies. Both MUS and SCD had higher sensitivities than DECT for acute gout flares and acute CPP crystal arthritis.
Authors: Pascal Richette; Michael Doherty; Eliseo Pascual; Victoria Barskova; Fabio Becce; Johann Castaneda; Malcolm Coyfish; Sylvie Guillo; Tim Jansen; Hein Janssens; Frédéric Lioté; Christian D Mallen; George Nuki; Fernando Perez-Ruiz; José Pimentao; Leonardo Punzi; Anthony Pywell; Alexander K So; Anne-Kathrin Tausche; Till Uhlig; Jakub Zavada; Weiya Zhang; Florence Tubach; Thomas Bardin Journal: Ann Rheum Dis Date: 2019-06-05 Impact factor: 19.103
Authors: W Zhang; M Doherty; T Bardin; V Barskova; P-A Guerne; T L Jansen; B F Leeb; F Perez-Ruiz; J Pimentao; L Punzi; P Richette; F Sivera; T Uhlig; I Watt; E Pascual Journal: Ann Rheum Dis Date: 2011-01-07 Impact factor: 19.103
Authors: Reva C Lawrence; David T Felson; Charles G Helmick; Lesley M Arnold; Hyon Choi; Richard A Deyo; Sherine Gabriel; Rosemarie Hirsch; Marc C Hochberg; Gene G Hunder; Joanne M Jordan; Jeffrey N Katz; Hilal Maradit Kremers; Frederick Wolfe Journal: Arthritis Rheum Date: 2008-01
Authors: David Bursill; William J Taylor; Robert Terkeltaub; Abhishek Abhishek; Alexander K So; Ana Beatriz Vargas-Santos; Angelo Lino Gaffo; Ann Rosenthal; Anne-Kathrin Tausche; Anthony Reginato; Bernhard Manger; Carlo Sciré; Carlos Pineda; Caroline van Durme; Ching-Tsai Lin; Congcong Yin; Daniel Arthur Albert; Edyta Biernat-Kaluza; Edward Roddy; Eliseo Pascual; Fabio Becce; Fernando Perez-Ruiz; Francisca Sivera; Frédéric Lioté; Georg Schett; George Nuki; Georgios Filippou; Geraldine McCarthy; Geraldo da Rocha Castelar Pinheiro; Hang-Korng Ea; Helena De Almeida Tupinambá; Hisashi Yamanaka; Hyon K Choi; James Mackay; James R ODell; Janitzia Vázquez Mellado; Jasvinder A Singh; John D Fitzgerald; Lennart T H Jacobsson; Leo Joosten; Leslie R Harrold; Lisa Stamp; Mariano Andrés; Marwin Gutierrez; Masanari Kuwabara; Mats Dehlin; Matthijs Janssen; Michael Doherty; Michael S Hershfield; Michael Pillinger; N Lawrence Edwards; Naomi Schlesinger; Nitin Kumar; Ole Slot; Sebastien Ottaviani; Pascal Richette; Paul A MacMullan; Peter T Chapman; Peter E Lipsky; Philip Robinson; Puja P Khanna; Rada N Gancheva; Rebecca Grainger; Richard J Johnson; Ritch Te Kampe; Robert T Keenan; Sara K Tedeschi; Seoyoung Kim; Sung Jae Choi; Theodore R Fields; Thomas Bardin; Till Uhlig; Tim Jansen; Tony Merriman; Tristan Pascart; Tuhina Neogi; Viola Klück; Worawit Louthrenoo; Nicola Dalbeth Journal: Ann Rheum Dis Date: 2019-09-09 Impact factor: 19.103
Authors: Tim Bongartz; Katrina N Glazebrook; Steven J Kavros; Naveen S Murthy; Stephen P Merry; Walter B Franz; Clement J Michet; Barath M Akkara Veetil; John M Davis; Thomas G Mason; Kenneth J Warrington; Steven R Ytterberg; Eric L Matteson; Cynthia S Crowson; Shuai Leng; Cynthia H McCollough Journal: Ann Rheum Dis Date: 2014-03-25 Impact factor: 19.103
Authors: Jennifer S Weaver; Ernest R Vina; Peter L Munk; Andrea S Klauser; Jamie M Elifritz; Mihra S Taljanovic Journal: J Clin Med Date: 2021-12-29 Impact factor: 4.241