Dual-energy computed tomography (DECT)- based monosodium urate (MSU)-coded plaques in peripheral arteries are strongly associated with calcifications and may not reflect genuine MSU crystal deposition in patients with gout, accord- ing to a study published in Seminars in Arthritis and Rheumatism. Therefore, such findings should not be a primary target when managing patients with gout, according to the study authors. Pa- tients with suspected crystal arthropathies were prospectively included in the CRYSTALILLE inception cohort to undergo baseline knees and ankles/feet DECT scans; treatment-naïve pa- tients with gout initiating treat-to-target urate- lowering therapy (ULT) underwent repeated DECT scans with concomitant serum urate level measurements at 6 and 12 months. The investigators determined the prevalence of DECT-based vascular MSU-coded plaques in knee arteries and assessed their association with the overall DECT volumes of soft-tissue MSU crystal deposition and coexistence of arterial calcifications. DECT attenuation parameters of vascular MSU-coded plaques were compared with dense calcified plaques, control vessels, control soft tissues, and tophi. The prevalence of DECT-based vascular MSU-coded plaques was comparable in patients with gout (24.6%) and controls (23.1%). Vascular MSU-coded plaques were strongly associated with coexist- ing arterial calcifications but not with soft-tissue MSU deposition.
