Clinical utility of dual-energy CT for evaluation of tophaceous gout

Radiographics. 2011 Sep-Oct;31(5):1365-75; discussion 1376-7. doi: 10.1148/rg.315115510.


Although diagnosing gout generally is straightforward, atypical disease may present a challenge if it is associated with unusual symptoms or sites, discordant serum urate level, or mimics of gout. Dual-energy computed tomography (CT) may be used to differentiate urate crystals from calcium by using specific attenuation characteristics, which may help diagnose gout. In patients with known tophaceous gout, dual-energy CT may be used for serial volumetric quantification of subclinical tophi to evaluate response to treatment. Given the utility of dual-energy CT in challenging cases and its ability to provide an objective outcomes measure in patients with tophaceous gout, dual-energy CT promises to be a unique and clinically relevant modality in the diagnosis and management of gout.

Publication types

  • Review

MeSH terms

  • Arthritis / diagnosis
  • Arthritis, Gouty / diagnostic imaging*
  • Arthritis, Gouty / metabolism
  • Calcinosis / diagnostic imaging
  • Calcinosis / metabolism
  • Crystallization
  • Diagnosis, Differential
  • Equipment Design
  • Foot Deformities, Acquired / diagnostic imaging
  • Foot Deformities, Acquired / metabolism
  • Hand Deformities, Acquired / diagnostic imaging
  • Hand Deformities, Acquired / metabolism
  • Humans
  • Hyperuricemia / complications
  • Osteomyelitis / diagnosis
  • Synovial Fluid / chemistry
  • Tendinopathy / diagnosis
  • Tomography, X-Ray Computed / methods*
  • Uric Acid / analysis*


  • Uric Acid