{"id":599,"date":"2020-02-07T11:41:38","date_gmt":"2020-02-07T19:41:38","guid":{"rendered":"http:\/\/vicrad.ca\/wiki\/?p=599"},"modified":"2020-02-07T11:42:03","modified_gmt":"2020-02-07T19:42:03","slug":"dect-gout-pitfalls","status":"publish","type":"post","link":"https:\/\/vicrad.ca\/wiki\/2020\/02\/07\/dect-gout-pitfalls\/","title":{"rendered":"DECT Gout Pitfalls"},"content":{"rendered":"\n<p class=\"gtfy-1\"> Email from Jon Hickle on February 7, 2020:<\/p>\n\n\n\n<p class=\"gtfy-4\">Not everything that\u2019s green is gout.&nbsp;<\/p>\n\n\n\n<p class=\"gtfy-7\">1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Nailbed.&nbsp; Commonly labeled as gout.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image gtfy-10\"><img decoding=\"async\" src=\"https:\/\/webmailci.viha.ca\/owa\/service.svc\/s\/GetFileAttachment?id=AAMkAGZlM2FhYThkLWNhZWEtNGQzMS1iMTU4LThhZjRkNWZiYjc4NgBGAAAAAABX%2Fi%2BWgmy0TLPYYns1qQkLBwDykk2hT4NaTq0%2Bol64kNazAAAAAAEMAADykk2hT4NaTq0%2Bol64kNazAAGRGluNAAABEgAQAOtUrtE%2FTVNOjDkd4nvTerQ%3D&amp;X-OWA-CANARY=Ncn31oJyN0ChNKf2Uo_S8MXmtLIErNcI3dT0B_7huZxpZizcbwJrH1xBHjnUaoCOkmH0LZMP3OU.\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"gtfy-13\">&nbsp;2.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Skin calluses and skin apposition.&nbsp; On the transverse images sent to PACS this looks like gout in the toe, but on coronal reformats it\u2019s the skin.&nbsp; Removing the gout overlay shows no mineralization in the soft tissues.<\/p>\n\n\n\n<figure class=\"wp-block-image gtfy-16\"><img decoding=\"async\" src=\"https:\/\/webmailci.viha.ca\/owa\/service.svc\/s\/GetFileAttachment?id=AAMkAGZlM2FhYThkLWNhZWEtNGQzMS1iMTU4LThhZjRkNWZiYjc4NgBGAAAAAABX%2Fi%2BWgmy0TLPYYns1qQkLBwDykk2hT4NaTq0%2Bol64kNazAAAAAAEMAADykk2hT4NaTq0%2Bol64kNazAAGRGluNAAABEgAQAOF0QfJ4AcNAoDEEU0%2FpEcY%3D&amp;X-OWA-CANARY=Ncn31oJyN0ChNKf2Uo_S8MXmtLIErNcI3dT0B_7huZxpZizcbwJrH1xBHjnUaoCOkmH0LZMP3OU.\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image gtfy-19\"><img decoding=\"async\" src=\"https:\/\/webmailci.viha.ca\/owa\/service.svc\/s\/GetFileAttachment?id=AAMkAGZlM2FhYThkLWNhZWEtNGQzMS1iMTU4LThhZjRkNWZiYjc4NgBGAAAAAABX%2Fi%2BWgmy0TLPYYns1qQkLBwDykk2hT4NaTq0%2Bol64kNazAAAAAAEMAADykk2hT4NaTq0%2Bol64kNazAAGRGluNAAABEgAQANZVxeof%2FM1NrCki5UY%2B9IA%3D&amp;X-OWA-CANARY=Ncn31oJyN0ChNKf2Uo_S8MXmtLIErNcI3dT0B_7huZxpZizcbwJrH1xBHjnUaoCOkmH0LZMP3OU.\" alt=\"\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image gtfy-22\"><img decoding=\"async\" src=\"https:\/\/webmailci.viha.ca\/owa\/service.svc\/s\/GetFileAttachment?id=AAMkAGZlM2FhYThkLWNhZWEtNGQzMS1iMTU4LThhZjRkNWZiYjc4NgBGAAAAAABX%2Fi%2BWgmy0TLPYYns1qQkLBwDykk2hT4NaTq0%2Bol64kNazAAAAAAEMAADykk2hT4NaTq0%2Bol64kNazAAGRGluNAAABEgAQAE3wHfRJc0hJiQkvKEjpBn0%3D&amp;X-OWA-CANARY=Ncn31oJyN0ChNKf2Uo_S8MXmtLIErNcI3dT0B_7huZxpZizcbwJrH1xBHjnUaoCOkmH0LZMP3OU.\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"gtfy-25\">&nbsp;3.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Tendons.&nbsp; When the x-ray beam is shot down the length of a tendon, the algorithm will produce \u201cgreen dot artifacts\u201d or GDAs.&nbsp; Urate can also deposit in tendons, so checking in syngo or on the routine non contrast images is important to correlate for focal areas of mineralization. Usually these are chunkier than these little dots.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image gtfy-28\"><img decoding=\"async\" src=\"https:\/\/webmailci.viha.ca\/owa\/service.svc\/s\/GetFileAttachment?id=AAMkAGZlM2FhYThkLWNhZWEtNGQzMS1iMTU4LThhZjRkNWZiYjc4NgBGAAAAAABX%2Fi%2BWgmy0TLPYYns1qQkLBwDykk2hT4NaTq0%2Bol64kNazAAAAAAEMAADykk2hT4NaTq0%2Bol64kNazAAGRGluNAAABEgAQADHth5Z2oZRErSCrAkeLA2o%3D&amp;X-OWA-CANARY=Ncn31oJyN0ChNKf2Uo_S8MXmtLIErNcI3dT0B_7huZxpZizcbwJrH1xBHjnUaoCOkmH0LZMP3OU.\" alt=\"\"\/><\/figure>\n\n\n\n<p class=\"gtfy-31\">&nbsp;If something is labeled green and is mineralized on the CT, you can be confident that what you\u2019re looking at is truly urate.&nbsp;<\/p>\n\n\n\n<p class=\"gtfy-34\">Jon <\/p>\n\n\n\n<p class=\"gtfy-37\">Another decent article on the topic:<\/p>\n\n\n\n<div class=\"wp-block-file gtfy-40\"><a href=\"https:\/\/vicrad.ca\/wiki\/wp-content\/uploads\/2020\/02\/AJR-gout-artifacts-DECT.pdf\"> Artifacts in Dual-Energy CT Gout Protocol: A Review of 50 Suspected Cases With an Artifact Identification Guide (AJR 2014)<\/a><a href=\"https:\/\/vicrad.ca\/wiki\/wp-content\/uploads\/2020\/02\/AJR-gout-artifacts-DECT.pdf\" class=\"wp-block-file__button\" download>Download<\/a><\/div>\n\n\n\n<p class=\"gtfy-43\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Email from Jon Hickle on February 7, 2020: Not everything that\u2019s green is gout.&nbsp; 1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Nailbed.&nbsp; [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23,7],"tags":[],"class_list":["post-599","post","type-post","status-publish","format-standard","hentry","category-ct","category-musculoskeletal"],"_links":{"self":[{"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/posts\/599","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/comments?post=599"}],"version-history":[{"count":2,"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/posts\/599\/revisions"}],"predecessor-version":[{"id":602,"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/posts\/599\/revisions\/602"}],"wp:attachment":[{"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/media?parent=599"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/categories?post=599"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vicrad.ca\/wiki\/wp-json\/wp\/v2\/tags?post=599"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}