This gouty foot DECT image, which I’ve used to illustrate Running On Gouty Feet, is from:
- Tendon involvement in the feet of patients with gout: a dual-energy CT study
- Dalbeth N, Kalluru R, Aati O, Horne A, Doyle AJ, McQueen FM.
- Ann Rheum Dis. 2013 Sep 1;72(9):1545-8.
Here is my layman’s review of the abstract.
Gouty Foot DECT Report
Gouty Foot DECT Report Objectives
To examine the frequency and patterns of uric acid crystal deposits in tendons and ligaments in patients with gout using Dual Energy Computed Tomography (DECT).
Gouty Foot DECT Report Methods
Ninety-two patients with tophaceous gout had DECT scanning of both feet. Two readers scored the DECT scans for uric acid crystal deposits at 20 tendon/ligament sites and 42 bone sites (total 1840 tendon/ligament sites and 3864 bone sites).
Gouty Foot DECT Report Results
Uric acid crystal deposits were observed by both readers in 199/1840 (10.8%) tendon/ligament sites and in 399/3864 (10.3%) bone sites. The affected tendon/ligament sites were:
- Achilles tendon (39.1% of all Achilles tendons)
- Peroneal tendons (18.1%). These are the two tendons that lie immediately behind the ankle bone.
- Tibialis anterior and the extensor tendons(7.6–10.3%). These are on the top, front of the foot.
- Other tendons, plantar fascia (bottom of foot) and deltoid ligaments (ankle) were rarely involved (
The point where the Achilles tendon connects to the foot was most affected. This connection point (called the enthesis) was also commonly affected at other tendon sites.
Gouty Foot DECT Report Conclusions
Tendons are commonly affected by uric acid crystal deposits in patients with tophaceous gout. The patterns of crystal deposition suggest that muscle strain or other local factors may contribute to deposition of uric acid crystals.