Diagnostic value of ultrasound versus dual-energy computed tomography in patients with different stages of acute gouty arthritis

Clinical Rheumatology - Previous studies of the diagnostic accuracy of ultrasound (US) and dual-energy computed tomography (DECT) in patients with gout have reported different results. The aim of...     

Ultrasound versus dual-energy computed tomography in patients with different stages of acute gouty arthritis: methodological issues on diagnostic value

Clinical Rheumatology -     

False-negative dual-energy computed tomography in a patient with acute gout

Gout is a painful inflammatory arthropathy caused by crystallization of monosodium urate within the joints. We present the case of a patient with primary gout who had positive results of joint aspiration and synovial biopsy for monosodium urate crystals in the third metacarpophalangeal joint but false-negative results of dual-energy computed tomography.     

The diagnosis of acute fatty liver of pregnancy by computed tomography

We describe 2 patients with biopsy-proven acute fatty liver of pregnancy in whom the diagnosis was suggested by the finding of uniform reduced attenuation values on computed tomography (CT) of the liver. The attenuation values returned to normal with resolution of signs and symptoms following delivery. CT of the liver provides a useful method for the diagnosis of acute fatty liver of pregnancy.     

Multidetector computed tomography for the diagnosis of acute pulmonary embolism

PURPOSE OF REVIEW: This review describes the accuracy of multidetector contrast-enhanced computed tomography (CT) for the diagnosis of acute pulmonary embolism, the role of clinical assessment and of venous phase imaging in combination with it, and the approach to the diagnosis. RECENT FINDINGS: The sensitivity of CT angiography was 83%, specificity 96% and positive predictive value 86%. Positive predictive values were 97% for pulmonary embolism in a main or lobar artery, 68% for a segmental vessel, and 25% for a subsegmental branch. A CT angiogram with concordant clinical probability assessment resulted in high predictive values, but with a discordant clinical probability, predictive value was low. The sensitivity for pulmonary embolism increased to 90% by using CT venography in combination with CT angiography.A negative D-dimer by the rapid enzyme-linked immunosorbent assay method with a low or moderate probability clinical assessment can safely exclude pulmonary embolism. Clinical probability assessment and D-dimer are recommended. In general, CT angiography in combination with CT venography is recommended, but the choice of diagnostic tests depends on the clinical situation. SUMMARY: The reliability of multislice CT angiography is enhanced by clinical assessment and CT venography used with it. Clinical assessment and D-dimer are recommended before imaging.