Diagnostic Impact of Subcutaneous Edema in Gouty Feet Detected by Dual-Energy Computed Tomography and Ultrasound
Author Information
Author(s): Julia Held, Christoph Strolz, Monique Reijnierse, Mihra Taljanovic, Pietro G. Lacaita, Miar Ouaret, Elke R. Gizewski, Günter Weiss, Andreas S. Klauser
Primary Institution: Medical University Innsbruck
Hypothesis
The study aims to evaluate the association and frequency of subcutaneous lymphedema in patients with gout primarily affecting the feet.
Conclusion
The presence of lymphedema in patients with gout is frequently associated with extra-articular manifestations of the disease.
Supporting Evidence
- Subcutaneous lymphedema was present in 58.2% of patients.
- 97.8% of patients with lymphedema had extra-articular MSU deposits.
- The DECT 120 protocol was significantly more sensitive for detecting peripheral MSU deposits (81%) compared to the DECT 150 protocol (34.2%).
- Age was significantly associated with the presence of lymphedema (p < 0.001).
- Positive ultrasound findings were strongly associated with lymphedema (OR: 9.75, p < 0.001).
- Extra-articular MSU deposits were the strongest predictor of lymphedema (OR: 43.3, p < 0.001).
- Both DECT and ultrasound findings showed strong associations with the presence of lymphedema (p < 0.001 for both).
- Comorbid conditions such as obesity, hypertension, and diabetes mellitus were identified as potential contributors to lymphatic dysfunction.
Takeaway
This study found that many people with gout have swelling in their feet, which is linked to other problems caused by the disease.
Methodology
The study involved 79 patients with acute gout who underwent ultrasound and dual-energy computed tomography to assess subcutaneous edema and gouty deposits.
Potential Biases
The retrospective nature of the study may lead to false negative imaging results if edema was not depicted in stored images.
Limitations
The study did not include a control group for comparison, which reduces the generalizability of the findings.
Participant Demographics
The cohort included 54 males (68.4%) and 25 females (31.6%) with a mean age of 71 years.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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