Gout
Conditions
Brief summary
The main objective is to describe urate deposits (especially in terms of distribution and volume) in soft tissues and bone, and joint erosions and destruction, in adult patients with gout.
Detailed description
Gout is the result of hyperuricemia, itself a consequence of a disorder of purine metabolism. This hypuricemia can lead to the deposition of sodium urate crystals in the soft tissues. It is the deposition of sodium urate crystals in and near the joints that causes an intense local inflammatory reaction with episodes of acute joint pain, swelling and functional disability. In the long term, uratic concretions in the soft tissues (tophus) occur, the joints are destroyed (uratic arthropathies), the kidneys also (gouty nephropathy). Dual-energy CT (Computed Tomography) is a relatively recent technique that allows the identification of certain materials through the analysis of the difference in attenuation of the material exposed to two different X-ray spectra. This technique identifies the crystalline component of tophus.
Interventions
DIAGNOSTIC_TESTDual-energy computed tomography
Dual-energy scanner examinations stored in the PACS (medical imagery) at Lariboisière Hospital are to be analyzed retrospectively and prospectively
Sponsors
Canon Medical Systems, USA
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age greater than or equal to 18 years old; * Patient with a gout according to ACR (American College of Rheumatology) criteria; * Affiliated with a social security scheme. * Dual-energy scanner examinations stored in the PACS at Lariboisière Hospital
Exclusion criteria
* Pregnant or breastfeeding woman.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Descriptive analysis of joint erosions and destruction | The day of the CT examination | Descrition of joint erosions and destruction :erosion size (mm) and location (joint), joint destruction (space narrowing, joint collapse, joint ankylosis). |
| Soft tissue tophus description | The day of the CT (computed tomography) examination | Description of soft tissue tophus in terms of location, size, density at high and low energy |
| Distribution of urate deposits | The day of the CT examination | Distribution of urate deposits in soft tissues and bone, and joint erosions and destruction |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reproducibility of a scoring system | The day of the CT examination | To develop and evaluate the reproducibility of a scoring system for tophaceous load and structural damage using a dual energy CT. We will try to developp a scoring system combining the tophus load (total tophus volume) and the erosion score (total erosion score). |
| Correlation of the descriptive parameters on dual-energy CT with clinical data | The day of the CT examination | to correlate the descriptive parameters on dual-energy CT with clinical data, including disease history and therapeutic management, and serum urate level. |
| Tophus texture | The day of the CT examination | To evaluate tophus texture. The texture of the tophus will be approached qualitatively (homogeneous/heterogeneous) and according to its density (Hounsfield unit) and to the percentage of tophus color-coded by the dual energy analyse. |
| Bone mineral density | The day of the CT examination | To evaluate the bone mineral density at the distal radius and correlate it with tophaceous load and joint structural damage. A region of interest at the distal radius (one centimeter above the joint space) will be placed using the computer mouse to obtained the bone mineral density (in Hounshield unit, mean bone mineral density within the ROI (Region Of Interest)). |
| Variations in tophaceous burden | The day of the CT examination | To study the variations in tophaceous burden according to the choice of technical parameters for deposit analysis.The parameters of dual energy analysis (threshold, optional filter to remove noise, gradients of dual-energy) change the quantitative value provided by the manufacturer. This outcome will be the urate volume obtained at different parameters |
| Link between tophus and erosions | The day of the CT examination | To analyze the relationships between bone erosion scores and urate volume (correlation between quantitative values) |
Countries
France
Contacts
Primary ContactValérie BOUSSON, PUPH
Backup ContactValérie BOUSSON, PUPH
Outcome results
None listed