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. 2023 Mar 19;12(3):215-224.
doi: 10.2478/jtim-2022-0066. eCollection 2024 Jun.

Single photon emission computed tomography/computed tomography imaging of gouty arthritis: A new voice

Yan Wang  1 , Yan Zha  1   2 , Lin Liu  1   3 , Ang Liao  1 , Ziqiang Dong  1 , Neil Roberts  4 , Yaying Li  1
Affiliations

Single photon emission computed tomography/computed tomography imaging of gouty arthritis: A new voice

Yan Wang et al. J Transl Int Med. .

Abstract

Gouty arthritis, often referred to simply as gout, is a disorder of purine metabolism characterized by the deposition of monosodium urate monohydrate (MSU) crystals in multiple systems and organs, especially in joints and their surrounding soft tissue. Gout is a treatable chronic disease, and the main strategy for effective management is to reverse the deposition of MSU crystals by uric acid reduction, and to prevent gout attacks, tophi deposition and complications, and thereby improve the quality of life. However, the frequent association of gout with other conditions such as hypertension, obesity, cardiovascular disease, diabetes, dyslipidemia, chronic kidney disease (CKD) and kidney stones can complicate the treatment of gout and lead to premature death. Here, we review the use of medical imaging techniques for studying gouty arthritis with special interest in the potential role of single photon emission computed tomography (SPECT)/computed tomography (CT) in the clinical management of gout and complications (e.g., chronic kidney disease and cardiovascular disease).

Keywords: 99mTc; advanced; chronic kidney disease; gout; radiopharmaceutical; single photon emission computed tomography/computed tomograph.

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Conflict of interest statement

Conflict of Interest None of the authors has any conflict of interest to declare.

Figures

Figure 1
Figure 1
A flowchart of demonstration for imaging of gout. MRI: magnetic resonance imaging; MSU: monosodium urate monohydrate; DECT: dual energy computed tomography; US: ultrasound; SPECT: single photon emission computed tomography; CT: computed tomography.
Figure 2
Figure 2
A 66-year-old elderly male. Postoperative pathological diagnosis of the lumbar spine: gout nodules. Anterior and posterior whole body views of 99mTc-MDP skeletal scintigraphy are shown. (A) Multiple regions of anomalous uptake of 99mTc-MDP were detected in the lumbar 1/2 right, right rotoclavicular, knee and ankle joints. (B–E) SPECT/CT can synchronize the case of bone, which enables the acquisition of synchronous imaging information of metabolism (focal anomalous uptake of 99mTc-MDP can be seen in an intra-spinal canal nodule at level L1/2 [white triangle]) and bone destruction in the gouty lesion area (bone erosions can be seen in the right inter-apophyseal joints at levels L1/2 [white arrow] and L2/3 [blue arrow]).[64] MDP: methylene diphosphonate; SPECT: single photon emission computed tomography; CT: computed tomography.
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