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European Radiology
Published in: European Radiology 10/2018

Open Access 01-10-2018 | Musculoskeletal

Gout of hand and wrist: the value of US as compared with DECT

Authors: Andrea S. Klauser, Ethan J. Halpern, Sylvia Strobl, Mohamed M. H. Abd Ellah, Johann Gruber, Rosa Bellmann-Weiler, Thomas Auer, Gudrun Feuchtner, Werner Jaschke

Published in: European Radiology | Issue 10/2018

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Abstract

Objectives

The purpose of this study was to compare findings of ultrasound (US) with dual-energy CT (DECT) in patients presenting with suspected gouty hand and wrist arthritis.

Methods

This prospective study included 180 patients (136 men and 44 women, age range, 31– 94 years; mean age, 65.9 years) with an initial clinical diagnosis of acute gouty arthritis who underwent DECT and US examination. Intra- and extra-articular findings of each modality were tabulated and calculated with DECT as gold standard.

Results

The final diagnosis of gout was positive in 97/180 patients (53.9%) by DECT, an alternative diagnosis confirmed in 83 patients. US showed a sensitivity of 70.1% (extra-articular: 42.5%, p < 0.0001; intra-articular: 80.3%, p = 0.14) and specificity of 51%. The double contour sign (DCS) was present in 58/61 patients with a positive US study for intra-articular gout (95.1%).

Conclusions

Sensitivity of US for diagnosis of gouty arthritis in hand and wrist is limited, particularly with respect to extra-articular urate deposition. The DCS is the most sensitive sign for the assessment of gouty hand and wrist arthritis by US.

Key points

• Sensitivity of US for diagnosis of gouty arthritis in hand and wrist is limited, particularly with respect to extra-articular gouty deposits.
• The double contour sign is the most sensitive finding for the assessment of gouty hand and wrist arthritis by US.
• Although the sensitivity of US for diagnosis of gouty hand and wrist arthritis is limited, it can be used as a first-line imaging modality in the presence of the DCS.
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Metadata
Title
Gout of hand and wrist: the value of US as compared with DECT
Authors
Andrea S. Klauser
Ethan J. Halpern
Sylvia Strobl
Mohamed M. H. Abd Ellah
Johann Gruber
Rosa Bellmann-Weiler
Thomas Auer
Gudrun Feuchtner
Werner Jaschke
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5363-9

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