News | April 01, 2014

Study Finds CT Scans Help Catch Gout Cases Missed by Traditional Tests

Accurate diagnosis key because painful disease treated differently than other forms of arthritis

April 1, 2014 — Gout is on the rise among U.S. men and women, and the standard way to check for gout is by drawing fluid or tissue from an affected joint and looking for uric acid crystals, a test known as a needle aspirate. In a new Mayo Clinic study, X-rays known as dual-energy CT (computed tomography) scans found gout in one-third of patients whose aspirates tested negative for the disease. The CT scans allowed rheumatologists to diagnose gout and treat those patients with the proper medication. These results are published in the Annals of the Rheumatic Diseases, the European League Against Rheumatism journal.

The study tested the usefulness of CT scans in finding uric acid crystals around joints across a spectrum of gout. The researchers found CT scans worked particularly well in detecting gout in patients who had experienced several gout-like flares but whose previous needle aspirates came back negative. After CT scans found what appeared to be uric acid crystals, ultrasound-guided aspirates were taken in those areas and tested for urate crystals.

"These were in part patients that had been falsely diagnosed with diseases like rheumatoid arthritis or labeled with a different type of inflammatory arthritis, resulting in a completely different and often not effective treatment approach," says first author Tim Bongartz, M.D., a Mayo Clinic rheumatologist. "And there were patients who remained undiagnosed for several years with, for example, chronic elbow symptoms or Achilles tendon systems, where the CT scan then helped us to pick up uric acid deposits."

The study isn't meant to suggest that CT scans should be the first test used to look for gout, Bongartz says. Needle aspirates work well in most cases, and the research showed CT scans weren't as effective a diagnostic tool among patients having their first gout flare-up, he says. In some of those acute gout cases, needle aspirates found uric acid crystals, but CT scans didn't.

Gout is often thought of as a man's disease and associated with sudden sharp, burning pain in the big toe. And gout can hit more than that: Other joints including parts of the feet, ankles, knees, fingers, wrists and elbows can be affected. "The first flare of gout most commonly occurs in the big toe, but gout can affect pretty much every joint in the body, and the more gout flares you have the more likelihood that other joint areas will be affected," Bongartz says.

An accurate and early gout diagnosis is crucial because gout patients are treated with different medication than people with other forms of inflammatory arthritis, and proper medication and dietary changes can help prevent further gout attacks and the spread of the disease to other joints.

"What we are learning from the dual-energy CT scans has really changed our perception of where gout can occur and how it can manifest," Bongartz says. "The ability to visualize those deposits clearly broadens our perspective on gout."

For more information: www.mayoclinic.org

Related Content

Hospital for Special Surgery Invests in Sectra Orthopedic 3-D Planning Software
News | Orthopedic Imaging | January 18, 2018
January 18, 2018 – International medical imaging IT and cybersecurity company Sectra announces that Hospital for Spec
Philips Introduces Technology Maximizer Program for Imaging Equipment Upgrades
Technology | Imaging | January 17, 2018
January 17, 2018 — Philips recently announced the launch of Technology Maximizer, a cross-modality program designed t
Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Smartphone Addiction Creates Imbalance in Brain
News | Mobile Devices | January 11, 2018
Researchers have found an imbalance in the brain chemistry of young people addicted to smartphones and the internet,...
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...
Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
Overlay Init