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Dual-energy CT scans of ligaments and bones in patients with tophaceous gout showed patterns of monosodium urate crystal deposition suggestive of a role for biomechanical strain. The Achilles tendon was the most commonly involved site.
Using dual-energy CT (DECT) scans, rheumatologists in New Zealand have found a deposition of monosodium urate (MSU) crystals is likelier in specific tendons among patients with tophaceous gout; i.e. the greater the mechanical strain, the more likely the deposition of MSU crystals.
The study involved 92 patients with tophaceous gout, who underwent DECT scans of both feet at the Bone and Joint Research Group of the University of Auckland, New Zealand. Each subject underwent scans at 20 tendon/ligament sites and 42 bone sites.
Readers scoring the results found crystal deposition in 199 of the ligament scans (10.8%) and in 399 (10.3%) of the bone scans, with the Achilles tendon being the most commonly involved site at 39.1%. Tibialis anterior and extensor tendons were less commonly involved, and the flexor tendons, plantar fascia, and deltoid ligaments were rarely involved.