PT  - JOURNAL ARTICLE
AU  - Penny Wang
AU  - Stacy E Smith
AU  - Rajesh Garg
AU  - Fengxin Lu
AU  - Alyssa Wohlfahrt
AU  - Anarosa Campos
AU  - Kathleen Vanni
AU  - Zhi Yu
AU  - Daniel H Solomon
AU  - Seoyoung C Kim
TI  - Identification of monosodium urate crystal deposits in patients with asymptomatic hyperuricemia using dual-energy CT
AID  - 10.1136/rmdopen-2017-000593
DP  - 2018 Mar 01
TA  - RMD Open
PG  - e000593
VI  - 4
IP  - 1
4099  - http://rmdopen.bmj.com/content/4/1/e000593.short
4100  - http://rmdopen.bmj.com/content/4/1/e000593.full
SO  - RMD Open2018 Mar 01; 4
AB  - Objectives Dual-energy CT (DECT) scan is a sensitive and specific tool used to visualise and quantify monosodium urate (MSU) crystal deposits in the joints. Few studies have examined MSU crystal deposits in patients with asymptomatic hyperuricemia (ie, hyperuricemia in the absence of gout) using DECT.Methods We conducted a prospective, non-interventional cross-sectional study to detect MSU crystal deposits on DECT scans among patients with asymptomatic hyperuricemia. We also examined patient factors associated with subclinical MSU crystal deposits. Out of 130 subjects aged ≥40 years with metabolic syndrome screened for serum uric acid (sUA) levels ≥6.5 mg/dL, 46 underwent a foot/ankle DECT scan.Results The mean age of the study participants was 62 (±8) years, 41% were men and the mean sUA level was 7.8 (±1.0) mg/dL. Seven (15%) of 46 patients had MSU crystal deposits on DECT with a mean total volume of 0.13 (±0.14) cm3. In the univariable logistic regression analysis, older age had a significant association with presence of MSU crystal deposits (OR 1.20, 95% CI 1.03 to 1.39), but sUA did not (OR 1.36, 95% CI 0.63 to 2.95). In the univariable analysis, sUA levels showed a trend towards a modest linear association (β=0.11, P=0.09) with total volume of MSU crystal deposits.Conclusions Fifteen per cent of patients with asymptomatic hyperuricemia had subclinical MSU crystal deposits on foot/ankle DECT scans. Older age, but not sUA, was significantly associated with presence of subclinical MSU crystal deposits among patients with asymptomatic hyperuricemia. Clinical significance of these subclinical MSU crystal deposits needs to be determined.