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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma


IMPACT FACTOR 2018: 1.239

CiteScore 2018: 1.22

SCImago Journal Rank (SJR) 2018: 0.507
Source Normalized Impact per Paper (SNIP) 2018: 0.562

Online
ISSN
2191-0251
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Volume 29, Issue 5

Issues

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

Nan Sun / Shiling Zhong
  • Department of Pediatric Rheumatoid Immunity, Ningbo Women and Children’s Hospital, Ningbo, P.R. China
  • Other articles by this author:
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/ Yunyan Li
  • Department of Pediatric Rheumatoid Immunity, Ningbo Women and Children’s Hospital, Ningbo, P.R. China
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/ Ling Wu
  • Department of Pediatric Rheumatoid Immunity, Ningbo Women and Children’s Hospital, Ningbo, P.R. China
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/ Yazhen Di
  • Corresponding author
  • Department of Pediatric Rheumatoid Immunity, Ningbo Women and Children’s Hospital, 339 Liuting Street, Ningbo, Zhejiang 315012, P.R. China, Phone: +86-574-83887082
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Published Online: 2016-03-16 | DOI: https://doi.org/10.1515/jpem-2015-0290

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.

Keywords: children; dual-energy CT; hyperuricemia; joint damage; urate crystals

References

  • 1.

    Lu X, Li X, Zhao Y, Zheng Z, Guan S, et al. Contemporary epidemiology of gout and hyperuricemia in community elderly in Beijing. Int J Rheum Dis 2014;17:400–7.Web of ScienceGoogle Scholar

  • 2.

    Roddy E, Choi HK. Epidemiology of gout. Rheum Dis Clin North Am 2014;40:155–75.Google Scholar

  • 3.

    Saag KG, Choi H. Epidemiology, risk factors, and lifestyle modifications for gout. Arthritis Res Ther 2006;8(Suppl 1):S2.CrossrefGoogle Scholar

  • 4.

    Liu CS, Li TC, Lin CC. The epidemiology of hyperuricemia in children of Taiwan aborigines. J Rheumatol 2003;30:841–5.Google Scholar

  • 5.

    Pineda C, Fuentes-Gomez AJ, Hernandez-Diaz C, Zamudio-Cuevas Y, Fernández-Torres J, et al. Animal model of acute gout reproduces the inflammatory and ultrasonographic joint changes of human gout. Arthritis Res Ther 2015;17:37.Google Scholar

  • 6.

    Henriques CC, Monteiro A, Lopez B, Sequeira L, Panarra A, et al. Juvenile gout: rare and aggressive. Br Med J Case Reports 2012; 2012. doi: 10.1136/bcr.12.2011.5345.CrossrefGoogle Scholar

  • 7.

    Swan A, Amer H, Dieppe P. The value of synovial fluid assays in the diagnosis of joint disease: a literature survey. Ann Rheu Dis 2002;61:493–8.Google Scholar

  • 8.

    Choi HK, Burns LC, Shojania K, Koenig N, Reid G, et al. Dual energy CT in gout: a prospective validation study. Ann Rheum Dis 2012;71:1466–71.Web of ScienceGoogle Scholar

  • 9.

    Desai MA, Peterson JJ, Garner HW, Kransdorf MJ. Clinical utility of dual-energy CT for evaluation of tophaceous gout. Radiographics 2011;31:1365–75; discussion 76–7.Web of ScienceGoogle Scholar

  • 10.

    Choi HK, Al-Arfaj AM, Eftekhari A, Munk PL, Shojania K, et al. Dual energy computed tomography in tophaceous gout. Ann Rheum Dis 2009;68:1609–12.Web of ScienceGoogle Scholar

  • 11.

    Shi D, Xu JX, Wu HX, Wang Y, Zhou QJ, et al. Methods of assessment of tophus and bone erosions in gout using dual-energy CT: reproducibility analysis. Clin Rheum 2015;34:755–65.Google Scholar

  • 12.

    Glazebrook KN, Guimaraes LS, Murthy NS, Black DF, Bongartz T, et al. Identification of intraarticular and periarticular uric acid crystals with dual-energy CT: initial evaluation. Radiology 2011;261:516–24.Google Scholar

  • 13.

    Liu H, Zhang XM, Wang YL, Liu BC. Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol 2014;27:653–8.Web of ScienceGoogle Scholar

  • 14.

    Group of China Obesity Task F. [Body mass index reference norm for screening overweight and obesity in Chinese children and adolescents]. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2004;25:97–102.Google Scholar

  • 15.

    Dalbeth N, House ME, Aati O, Tan P, Franklin C, et al. Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout: a dual energy CT study. Ann Rheum Dis 2015;74:908–11.Web of ScienceGoogle Scholar

  • 16.

    Perez-Ruiz F, Dalbeth N, Bardin T. A review of uric acid, crystal deposition disease, and gout. Adv Ther 2015;32:31–41.Web of ScienceGoogle Scholar

  • 17.

    Mallinson PI, Reagan AC, Coupal T, Munk PL, Ouellette H, et al. The distribution of urate deposition within the extremities in gout: a review of 148 dual-energy CT cases. Skeletal Radiol 2014;43:277–81.Web of ScienceGoogle Scholar

  • 18.

    Huppertz A, Hermann KG, Diekhoff T, Wagner M, Hamm B, et al. Systemic staging for urate crystal deposits with dual-energy CT and ultrasound in patients with suspected gout. Rheumatol Int 2014;34:763–71.Web of ScienceGoogle Scholar

  • 19.

    Bongartz T, Glazebrook KN, Kavros SJ, Murthy NS, Merry SP. Dual-energy CT for the diagnosis of gout: an accuracy and diagnostic yield study. Ann Rheum Dis 2015;74:1072–7.Web of ScienceGoogle Scholar

About the article

Received: 2015-07-18

Accepted: 2016-01-04

Published Online: 2016-03-16

Published in Print: 2016-05-01


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 5, Pages 579–583, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0290.

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