TY - CHAP
T1 - Imaging in Gout
AU - Christiansen, Sara Nysom
AU - Terslev, Lene
AU - Slot, Ole
AU - Østergaard, Mikkel
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Conventional radiography (CR) has a long history in the diagnosis and assessment of gout, whereas ultrasonography (US), dual energy computed tomography (DECT) and magnetic resonance imaging (MRI) have gained increasingly important roles over the last few years. CR, US and DECT have been included in the 2015 Gout classification criteria. Imaging for diagnosis of gout has an especially important role when monosodium urate (MSU) crystal visualization by microscopy is not possible. There are three key aspects of gout, which are most relevant for imaging modalities to identify in regard to both diagnosis and monitoring of the disease: MSU deposition, joint inflammation and structural damage. The different modalities have varying capabilities in capturing these key features. CR and conventional computed tomography (CT) have their strength in excellent visualization of structural bone damage such as erosions, and since bone erosions caused by gout have a characteristic appearance, both modalities may show changes indicating gout. However, the modalities do not identify MSU crystal deposits per se and they do not visualize joint inflammation. US and DECT are, in contrast to the other modalities, able to identify MSU crystal deposits. Furthermore, both modalities visualize structural damage caused by gout and US is able to visualize signs of joint inflammation. MRI is able to visualize both structural bone damage, joint inflammation and nodular structures recognizable as potential tophi, but the images produced by MRI are not specific for gout. In conclusion, imaging in gout, particularly US and DECT, shows very promising results, has provided important insights into the mechanisms of gout, and has great potential to allow non-invasive diagnosis and monitoring of gout.
AB - Conventional radiography (CR) has a long history in the diagnosis and assessment of gout, whereas ultrasonography (US), dual energy computed tomography (DECT) and magnetic resonance imaging (MRI) have gained increasingly important roles over the last few years. CR, US and DECT have been included in the 2015 Gout classification criteria. Imaging for diagnosis of gout has an especially important role when monosodium urate (MSU) crystal visualization by microscopy is not possible. There are three key aspects of gout, which are most relevant for imaging modalities to identify in regard to both diagnosis and monitoring of the disease: MSU deposition, joint inflammation and structural damage. The different modalities have varying capabilities in capturing these key features. CR and conventional computed tomography (CT) have their strength in excellent visualization of structural bone damage such as erosions, and since bone erosions caused by gout have a characteristic appearance, both modalities may show changes indicating gout. However, the modalities do not identify MSU crystal deposits per se and they do not visualize joint inflammation. US and DECT are, in contrast to the other modalities, able to identify MSU crystal deposits. Furthermore, both modalities visualize structural damage caused by gout and US is able to visualize signs of joint inflammation. MRI is able to visualize both structural bone damage, joint inflammation and nodular structures recognizable as potential tophi, but the images produced by MRI are not specific for gout. In conclusion, imaging in gout, particularly US and DECT, shows very promising results, has provided important insights into the mechanisms of gout, and has great potential to allow non-invasive diagnosis and monitoring of gout.
M3 - Book chapter
SN - 978-1-53611-781-3
T3 - Rheumatism and Musculoskeletal Disorders
SP - 101
EP - 134
BT - Gout
A2 - Perry, Martin Edward
ER -