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Ultrasound scans and dual energy CT identify tendons as preferred anatomical location of MSU crystal depositions in gouty joints

  • Imaging
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Abstract

Objective

The present study was performed to localize the articular deposition of monosodium urate (MSU) crystal in joints. We compare the detection efficiencies of dual-energy CT (DECT) and ultrasound scans.

Methods

Analyses by DECT and ultrasound were performed with 184 bilateral joints of the lower limbs of 54 consecutive gout patients. All joints were categorized into (1) knee, (2) ankle, (3) MTP1, and (4) MTP2, and sorted into those with and those without detectable MSU deposition. The comparison of the positive rate between DECT and ultrasound and the agreement was performed using the McNemar test and the Cohen’s κ coefficient, respectively. Next, we listed the MSU crystal deposition as assessed by ultrasound between the DECT-positive and -negative joints according to their interior structure. We included tendons, synovia, cartilage, subcutaneous tissue, etc.

Results

Among all joints, the percentages with MSU crystal deposition detected by DECT (99/184, 53.8%) and ultrasound (106/184, 57.6%) were comparable (P = 0.530 > 0.05). For MTP1 (21/34, 61.8%; 12/34, 35.3%; P < 0.05) and MTP2-5 (17/34, 50.0%; 10/34, 29.4%, P < 0.05), ultrasound and DECT were more efficient, respectively. The data concordance in 46 of 50 joints (92.00%; κ = 0.769, P < 0.05) for knee; and 27 of 34 joints (79.41%; κ = 0.588, P < 0.05) for MTP2-5 and suggested that tendons were the most frequent anatomical location of MSU crystal deposition.

Conclusions

The tendons are the most frequent anatomical location of MSU crystal depositions. The concordance rate of knee joints and MTP2-5 joints shows good agreement between DECT and ultrasound depending on the location.

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Funding

The study was funded by the National Natural Science Foundation of China 81273286 and International Collaborative Project in Science and Technology of the Sichuan province 2015HH0050.

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, West China Hospital, Sichuan University, 610041, Chengdu, China

    Yuan Yuan, Tong-ling Yuan, Yi Liu, Yu-bin Luo & Y. Zhao

  2. Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 646000, Luzhou, China

    Yuan Yuan & Yi Liu

  3. Department of Medical Imaging, West China Hospital, Sichuan University, 610041, Chengdu, China

    Chang Liu

  4. Department of Musculoskeletal Ultrasound, West China Hospital, Sichuan University, 610041, Chengdu, China

    Xi Xiang & Li Qiu

  5. Department of Internal Medicine 3, University of Erlangen-Nuremberg, 91054, Erlangen, Germany

    Martin Herrmann

Authors
  1. Yuan Yuan
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  2. Chang Liu
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  3. Xi Xiang
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  4. Tong-ling Yuan
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  5. Li Qiu
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  6. Yi Liu
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  7. Yu-bin Luo
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  8. Y. Zhao
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  9. Martin Herrmann
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Contributions

There are nine authors for the original article. The contributions of each author were: (1) The idea of this article was provided by YZ and MH. And YZ is the corresponding author who helped collect patients in the out-patient department. (2) YY was responsible for data collection, processing, drawing, charting, literature review, and article writing. (3) CL, QX and LQ provided specialized guidance of DECT and ultrasound. (4) TY provided rich experience of data collection, processing and article writing for YY. (5) YL, YL, YZ and MH finalized the article. All authors have read and approved this version of the article, and declare no financial or other relationships that could lead to a conflict of interest among authors.

Corresponding author

Correspondence to Y. Zhao.

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Conflict of interest

The authors declare that there are no conflicts of interest related to the publication of this paper.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Yuan, Y., Liu, C., Xiang, X. et al. Ultrasound scans and dual energy CT identify tendons as preferred anatomical location of MSU crystal depositions in gouty joints. Rheumatol Int 38, 801–811 (2018). https://doi.org/10.1007/s00296-018-3994-4

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  • DOI: https://doi.org/10.1007/s00296-018-3994-4

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