Introduction
Methods
Study design
Patients
Study outcomes
Interventions of selected patients
DECT
Testing of SF
Statistical analysis
Results
Age, mean (SD), (years) | 63.3 (13.6) |
Sex, (N, %) | |
Male | 100 (68) |
Female | 47 (32) |
Body mass index, mean (SD), (kg/m2) | 28.5 (4.9) |
Cardiovascular disease (N, %) | 57 (39) |
Diabetes mellitus (N, %) | 21 (14.4) |
Disease duration median (IQR), (years) | 3 (6.6) |
Frequency of attack during the past year (N, %) | |
0–2 | 51 (34.5) |
≥ 3 | 80 (54.1) |
Unknown | 17 (11.5) |
Uric acid levels between flares, mean (SD), (μmol/l) | 442.5 (124.0) |
Joint involvement at the moment of DECT (N, %) | |
MTP1 | 52 (62.8) |
Other joints | 93 (35.1) |
Unknown | 3 (2.0) |
Result microscopy of the index joint | |
Diagnostic joint aspiration of the index joint (N, %) | 86 (58.5) |
MSU crystals present (N, %) | 25 (17.0) |
MSU crystals absent (N, %) | 61 (41.5) |
Clinical evidence of tophi N, (%) | 26 (17.8) |
Urate lowering therapy (allopurinol, benzbromarone, and febuxostat use at the moment of DECT) (N, %) | |
Yes | 28 (19.3) |
No | 115 (80.0) |
Unknown | 4 (0.7) |
Joint fluid MSU positive (N, %) | Joint fluid MSU negative (N, %) | No joint fluid aspiration (N, %) | Total | |
---|---|---|---|---|
Positive DECT | 16 (10.88) | 25 (17.0) | 34 (23.12) | 75 (51) |
Negative DECT | 9 (6.12) | 36 (24.48) | 27 (18.4) | 72 (49) |
Total | 25 (17.0) | 61 (41.5) | 61 (41.5) | 147 (100) |
DECT scanned area | N, % | Positive DECT (N, % of all patients) |
---|---|---|
Ankles + feet | 70 (47.6) | 36 (24.5) |
Ankles + feet + hands + wrists | 28 (19.0) | 13 (8.8) |
Hands + wrists | 17 (11.6) | 5 (3.4) |
Ankles + feet + hands + wrists + elbow | 10 (6.8) | 8 (5.4) |
Ankles + feet+ knees | 8 (5.4) | 7 (4.8) |
Knees | 5 (3.4) | 3 (2.0) |
Elbow | 3 (2.0) | 0 (0) |
Other (sternoclavicular, shoulders) | 3 (2.0) | 0 (0) |
Ankles + feet + knees + hands + wrists + elbow | 2 (1.4) | 1 (0.7) |
Hands + wrists + elbow | 1 (0.7) | 1 (0.7) |
Total | 147 (100) | 74 (50.3) |
Therapeutic impact of results of DECT
OR (95% CI) |
p
| |
---|---|---|
Gender (reference: male gender) | 0.48 (0.24–0.99) | 0.04 |
Body mass index (per kg/m2) | 1.03 (0.96–1.11) | 0.36 |
Cardiovascular disease yes/no | 2.72 (1.36–5.42) | 0.04 |
Diabetes mellitus yes/no | 3.69 (1.26–10.71) | 0.01 |
Urate lowering therapy use at the moment of DECT yes/no | 2.6 (1.15–6.28) | 0.02 |
Disease duration years | 1.01 (1.005–1.02) | 0.01 |
Frequency of attacks per year | 1.2 (1.08–1.33) | 0.01 |
Uric acid levels between flares (per μmol/l) | 1.004 (1.001–1.007) | 0.008 |
Creatinine clearance (per ml/min) | 0.95 (0.92–0.99) | 0.01 |
Joint involvement at the moment of DECT: MTP1 or other joints | 1.69 (1.05–3.37) | 0.1 |
Past first metatarsophalangeal (MTP1) joint involvement yes/no | 3.37 (1.69–6.72) | 0.01 |
MSU crystals at microscopy yes/no | 1.62 (1.23–2.17) | 0.001 |
OR (95% CI) |
p
| |
---|---|---|
Cardiovascular disease yes/no | 3.07 (1.26–7.47) | 0.01 |
Disease duration (years) | 1.008 (1.001–1.016) | 0.03 |
Frequency of attack (per year) | 1.23 (1.07–1.42) | 0.01 |
Creatinine clearance (ml/min) | 2.03 (0.91–1.00) | 0.10 |