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Ultrasonography and dual-energy computed tomography provide different quantification of urate burden in gout: results from a cross-sectional study

Authors
  • Pascart, Tristan1, 2, 3
  • Grandjean, Agathe1
  • Norberciak, Laurène4
  • Ducoulombier, Vincent1
  • Motte, Marguerite1
  • Luraschi, Hélène1
  • Vandecandelaere, Marie1
  • Godart, Catherine1
  • Houvenagel, Eric1
  • Namane, Nasser5
  • Budzik, Jean-François5, 2
  • 1 Lille Catholic Hospitals, University of Lille, Department of Rheumatology, Lomme, F-59160, France , Lomme (France)
  • 2 EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, Lille, F-59000, France , Lille (France)
  • 3 Saint-Philibert Hospital, Rue du Grand But, Lomme, 59160, France , Lomme (France)
  • 4 Lille Catholic Hospitals, University of Lille, Department of Medical Research, Biostatistics, Lomme, F-59160, France , Lomme (France)
  • 5 Lille Catholic Hospitals, University of Lille, Department of Radiology, Lomme, F-59160, France , Lomme (France)
Type
Published Article
Journal
Arthritis Research & Therapy
Publisher
Springer Science and Business Media LLC
Publication Date
Jul 21, 2017
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s13075-017-1381-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundUltrasonography (US) and dual-energy computed tomography (DECT) can assess urate burden in gout. The objective of this study was to compare the quantification of urate deposition provided by US to the one provided by DECT.MethodsPatients with a diagnosis of gout were prospectively recruited to undergo quantification of urate deposition using US and DECT. US examination for tophi and the double contour (DC) sign was performed on the knees and feet and corresponding DECT scans provided volumes of tophi and of overall urate deposition. The primary endpoint was the intra-class correlation coefficient (ICC) of the volume of the index tophus measured by US and DECT and its 95% confidence interval (CI 95%).ResultsOf the 64 patients included, 34 presented with at least one tophus on US. DECT inter-reader agreement for urate deposition was perfect with an ICC of 1 (1–1) and good for the measurement of the index tophus with an ICC of 0.69 (0.47–0.83). The ICC for the measurement of the index tophus between the two techniques was poor with a value of 0.45 (0.1–0.71). The average ratio between the index tophi volume as assessed by DECT and US was 0.65. The number of DC-positive joints did not correlate with DECT volume of overall deposits (Spearman correlation coefficient of 0.23).ConclusionsDECT measurements of tophi give smaller volumes to the same tophi measured with US, and US signs of urate deposition in joints do not correlate with overall DECT volumes of extra-articular deposition.

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