J Korean Soc Radiol.  2023 Jan;84(1):212-225. 10.3348/jksr.2021.0003n.

Detection of Monosodium Urate Crystal of Hand and Wrist in Suspected Gouty Arthritis Patients on DualEnergy CT and Relationship with Serum Urate Level

• Choi H
• Ryu J
• Lee S
• Kim YJ
• Bang S

• KMID: 2539275
• DOI: http://doi.org/10.3348/jksr.2021.0003n

Abstract

Purpose
We retrospectively investigated the characteristics of patients with monosodium urate (MSU) deposits of the hand and wrist on dual-energy CT (DECT) compared to those without. We also attempted to determine the pattern of MSU distribution in DECT.
Materials and Methods
In total, 93 patients were included who had undergone DECT for evaluation of the hand or wrist pain under the clinical impression of gouty arthritis. The total volume of MSU deposits on DECT was calculated and the pattern of MSU distribution on DECT was analyzed. Also, the level of the serum urate at the time of DECT and the highest level of the serum urate of the patients were obtained from their records and the relationship between MSU and serum urate level was evaluated.
Results
The range of the volume of MSU deposits on DECT was 0.01–16.11 cm³ (average: 1.07 cm³). The average level of serum urate was significantly higher in the MSU positive group than that in the MSU negative group. MSU deposits were most frequently observed in the wrists followed by fingers and digitorum tendons.
Conclusion
On DECT, MSU deposits were most frequently detected in the wrist and related with high serum urate level.

Keyword

Arthritis; Gout; Wrist; Hand; Uric Acid; Multidetector Computed Tomography