Urate crystals deposition in the feet of overweight juveniles and those with symptomatic hyperuricemia: a dual-energy CT study

Abstract

BACKGROUND: The present study evaluated the clinical value of dual-energy computed tomography (DECT) for detecting urate crystals in juveniles with symptomatic hyperuricemia. METHODS: We recruited 24 juveniles (15 male and 9 female) who presented with symptomatic hyperuricemia. The mean body mass index (BMI) was 26.4 kg/m2 (standard deviation, SD 11.3 kg/m2). Fifteen juveniles (71.4%) were overweight. DECT scans of the feet were performed. For post-processing, a color-coding gout software protocol was used. RESULTS: Urate crystals deposition was observed in 21/24 (87.5%) juveniles with symptomatic hyperuricemia. Urate crystals were detected in or around the anatomic site included the first metatarsophalangeal (MTP) joints (5/24, 20.8%); the calcaneus (5/24, 20.8%); any other toe joints (3/24, 12.5%); the astragalus (3/24, 12.5%); the ankle joints (3/24, 12.5%); the metatarsals (2/24, 8.3%); the cuboid (1/24, 4.2%); and other parts of the feet (2/24, 8.3%). Importantly, urate crystals deposition weas located in the soft tissue (tendon/tendon insertion sites/entheses) around the above-mentioned sites in a majority of these patients. CONCLUSIONS: Urate crystals deposition can be detected by dual-energy CT in the feet of symptomatic hyperuricemia juveniles. DECT can be a valuable diagnostic tool for helping diagnose in juvenile gout.