Department of Radiology, Peking University Third Hospital, Beijing, China.
Int J Rheum Dis. 2022 Feb;25(2):147-153. doi: 10.1111/1756-185X.14249. Epub 2021 Nov 26.
To compare the characteristics of monosodium urate (MSU) crystal deposition at specific anatomical sites of the foot detected by dual-energy computed tomography in patients with different stages of gout.
This study included 101 patients with gout, 64 had early gout (<3 years) and 37 had late gout (>3 years). We retrospectively compared the total volumes of MSU crystals, the detection rates, and the morphology of MSU crystals at specific anatomical sites in the foot of the patients with different gout durations.
The total volume of MSU crystals in patients with early gout was significantly smaller than that in patients with late gout (P < 0.05). The detection rates and morphology of MSU crystals in the anterior calf tendons, ankle joints, tarsometatarsal joints, and metatarsophalangeal joints differed significantly between the patients with early and late gout (P < 0.05). There were no significant differences in the detection rates of submillimeter MSU crystals at the other specific anatomical sites, except for the tendons of the anterior calf, the ankle joint, and the metatarsal joint (P > 0.05). The submillimeter MSU crystal deposition was most common in the tendons of the posterior calf, the proportions in patients with early gout and late gout were 85.9% and 70.3%. Only submillimeter deposition existed in 52 patients (81.3%) with early gout and 11 patients (29.7%) with late gout at all sites of the foot.
Dual-energy computed tomography detection of submillimeter MSU crystal deposits in the foot is of great significance for the diagnosis of gout, especially along tendons.
比较双能 CT 检测不同痛风分期患者足部特定解剖部位单钠尿酸盐（MSU）晶体沉积的特征。
本研究纳入了 101 例痛风患者，64 例为早期痛风（<3 年），37 例为晚期痛风（>3 年）。我们回顾性比较了不同痛风病程患者足部 MSU 晶体总体积、检出率及特定解剖部位 MSU 晶体形态。
早期痛风患者的 MSU 晶体总体积明显小于晚期痛风患者（P<0.05）。早期和晚期痛风患者在前小腿肌腱、踝关节、跗跖关节和跖趾关节的 MSU 晶体检出率和形态差异有统计学意义（P<0.05）。除前小腿肌腱、踝关节和跖趾关节外，其他特定解剖部位的亚毫米 MSU 晶体检出率差异无统计学意义（P>0.05）。亚毫米 MSU 晶体沉积最常见于后小腿肌腱，早期和晚期痛风患者中的比例分别为 85.9%和 70.3%。52 例（81.3%）早期痛风患者和 11 例（29.7%）晚期痛风患者在足部所有部位均仅存在亚毫米沉积。
双能 CT 检测足部亚毫米 MSU 晶体沉积对痛风的诊断具有重要意义，尤其是在肌腱处。
