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Article

Diagnostic Impact of Subcutaneous Edema in Gouty Feet Detected by Dual-Energy Computed Tomography and Ultrasound

by
Julia Held
1,†,
Christoph Strolz
2,†,
Monique Reijnierse
3,
Mihra Taljanovic
4,5,
Pietro G. Lacaita
2,*,
Miar Ouaret
2,
Elke R. Gizewski
2,
Günter Weiss
1 and
Andrea S. Klauser
2
1
Department of Internal Medicine II, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
2
Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
3
Division of Musculoskeletal Radiology, Department of Radiology, Leiden University Medical Center, 2333 ZC Leiden, The Netherlands
4
Departments of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85724, USA
5
Department of Radiology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2024, 13(24), 7620; https://doi.org/10.3390/jcm13247620
Submission received: 4 November 2024 / Revised: 2 December 2024 / Accepted: 11 December 2024 / Published: 13 December 2024
(This article belongs to the Section Nuclear Medicine & Radiology)
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Abstract

Background: The objective of our study was to evaluate the association and frequency of subcutaneous lymphedema in patients with gout primarily affecting the feet. Methods: In 79 patients with acute gout, ultrasound (US) and dual-energy computed tomography (DECT) were performed to assess the presence of subcutaneous edema and extra- and intra-articular gouty deposits. In addition, the diagnostic utility of two post-processing DECT protocols were evaluated, comprising different minimum attenuation thresholds of 150 HU (DECT 150 protocol) and 120 HU (DECT 120 protocol), with the same maximum attenuation threshold (500 HU) and constant kilovoltage setting of tubes A and B at 80 and 140 kVp. Results: Subcutaneous lymphedema was present in 58.2% of patients, with a significant association with extra-articular monosodium urate (MSU) deposits (p < 0.001). Specifically, 97.8% of patients with lymphedema had extra-articular MSU deposits in DECT or US examination, while no cases of lymphedema were found in patients with exclusively intra-articular deposits. The DECT 120 protocol was significantly more sensitive for detecting peripheral MSU deposits (81%) compared to the DECT 150 protocol (34.2%, p < 0.001). Conclusions: Our findings demonstrate that the presence of lymphedema in patients with gout is frequently associated with extra-articular manifestations of the disease.
Keywords: lymphedema; gout; gouty arthritis; DECT; ultrasound lymphedema; gout; gouty arthritis; DECT; ultrasound

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MDPI and ACS Style

Held, J.; Strolz, C.; Reijnierse, M.; Taljanovic, M.; Lacaita, P.G.; Ouaret, M.; Gizewski, E.R.; Weiss, G.; Klauser, A.S. Diagnostic Impact of Subcutaneous Edema in Gouty Feet Detected by Dual-Energy Computed Tomography and Ultrasound. J. Clin. Med. 2024, 13, 7620. https://doi.org/10.3390/jcm13247620

AMA Style

Held J, Strolz C, Reijnierse M, Taljanovic M, Lacaita PG, Ouaret M, Gizewski ER, Weiss G, Klauser AS. Diagnostic Impact of Subcutaneous Edema in Gouty Feet Detected by Dual-Energy Computed Tomography and Ultrasound. Journal of Clinical Medicine. 2024; 13(24):7620. https://doi.org/10.3390/jcm13247620

Chicago/Turabian Style

Held, Julia, Christoph Strolz, Monique Reijnierse, Mihra Taljanovic, Pietro G. Lacaita, Miar Ouaret, Elke R. Gizewski, Günter Weiss, and Andrea S. Klauser. 2024. "Diagnostic Impact of Subcutaneous Edema in Gouty Feet Detected by Dual-Energy Computed Tomography and Ultrasound" Journal of Clinical Medicine 13, no. 24: 7620. https://doi.org/10.3390/jcm13247620

APA Style

Held, J., Strolz, C., Reijnierse, M., Taljanovic, M., Lacaita, P. G., Ouaret, M., Gizewski, E. R., Weiss, G., & Klauser, A. S. (2024). Diagnostic Impact of Subcutaneous Edema in Gouty Feet Detected by Dual-Energy Computed Tomography and Ultrasound. Journal of Clinical Medicine, 13(24), 7620. https://doi.org/10.3390/jcm13247620

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