Assessment of value of DECT scan in diagnosing acute arthritis, caused by gout
ID
Source
Brief title
Condition
- Joint disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The sensitivity and specificity (95% CI) of DECT scanning for the detection of
MSU deposition will be calculated. The area under receiver operating
characteristic curve (AUC-ROC) will be employed to evaluate the screening
method*s performance.
Secondary outcome
Identify the clinical features and laboratory variables that affect the primary
outcome measure of positive DECT scan for lesions suggestive of uric acid
deposition in patients with acute mono or oligo arthritis.
Establish the additive value of ultrasound guided joint aspiration in patients
in whom the first aspirate demonstrated no microscopic MSU and /or no synovial
fluid
Establish the additive value of ultrasound guided joint aspiration of DECT
lesions suggestive of gout in patients in whom the earlier aspirate(s)
demonstrated no microscopic MSU and /or no synovial fluid.
Cost effectiveness analysis of different diagnostic strategies.
Patient satisfaction: What does the patient experience as the most
patient-friendly way of diagnosing gout: DECT scan, ultrasound-guided joint
aspiration or blind aspiration?
Background summary
Gout is a disease with growing incidence and complexity due to increased life
expectancy, co-morbidity and medication. The disease can be diagnosed by
microscopy, demonstrating monosodium uric acid (MSU) in synovial fluid of the
affected joint or in tophi (subcutaneous or peritendinous MSU depositions). In
daily practice, however, the diagnosis is difficult to ascertain due to
sampling error (no synovial fluid acquired because the needle was not exactly
placed in the affected joint, or the location of the gout might have been
extra-articular e.g. around tendons) or to a different cause of acute arthritis
(e.g. infection, reactive arthritis). Recently, Dual Energy CT scan has become
available. This technique allows the visualization and quantification of MSU.
Although imaging modalities such as DECT show promise in the classification of
gout, the studies to date have been small and have primarily involved people
with established disease.
A study with cross-sectional design in which patients for whom the clinical
questions *does this patient have gout?* are referred for participation may
contribute to assess the value of DECT scan in diagnosing acute arthritis
caused by gout.
Study objective
Assessment of value of DECT scan in diagnosing acute arthritis, caused by gout
Study design
Prospective
Study burden and risks
Benefit: mogelijk eerder stellen van de diagnose
Risk: minimal radiation exposure 0.5 mSV (exposure healthy person 3,6
mSv/year)
Maatweg 3
Amersfoort 3813 TZ
NL
Maatweg 3
Amersfoort 3813 TZ
NL
Listed location countries
Age
Inclusion criteria
Age > 18 years
Mono or oligo arthritis (2-3 swollen joints)
Indication for diagnostic aspiration of an inflamed joint in which gout is one of the possibilities
Exclusion criteria
Polyarthritis (>=4 swollen joint);
Chrystal proven gout in history
Patient is on uric acid lowering therapy (Allopurinol, Benzbromaron, Febuxostat)
Hip arthritis
Metal or prosthesis of the inflamed joint
Highly suspicion of infectious arthritis
Pregnancy
Contra indication of joint aspiration (skin infection, hemophilia)
No informed consent
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
In other registers
| Register | ID |
|---|---|
| CCMO | NL54454.100.15 |
| OMON | NL-OMON24638 |