How do individual monosodium urate depositions respond to urate-lowering therapy? A systematic evaluation using the dual-energy CT modality
Authors' conclusion
MSU depositions in gout patients responded to ULT in a similar way across sites and without signs of calcification. Crystal resolution occurred evenly throughout individual lesions following first-order kinetics, suggesting that MSU deposition resolution does not occur only from the outside-and-in-like a melting ice cube-which otherwise might seem comprehensible.
Study context
- Population
- Microscopically verified people with gout initiating/increasing urate-lowering therapy (ULT); Dual-energy CT (DECT) of knees and feet (MTP1 and patella tendons)
- Outcome
- Density reduction of complete and core part of individual MSU depositions during ULT; changes in effective atomic numbers as a sign of tophi calcification
- Follow-up
- 3, 6 and 12 months
Methodological detailsserial DECT at baseline, 3, 6 and 12 months, superimposition of DECT scans
- Serial DECT at baseline, 3, 6 and 12 months
- Superimposition of DECT scans
Main finding
As reported in the abstract
- At baseline, monosodium urate (MSU) deposition densities relatively homogeneous across sites in the same patient and across individual lesions (complete vs core)
- During follow-up, density decreased in all patients; decreases similar across sites and lesions (complete vs core)
- Decreases more pronounced in months 0-6 than 6-12 for both complete and core part, a trend more resembling first-order kinetics than linear decreases
- Effective atomic numbers unchanged during follow-up
Observational data: associations, not effects.
Original publication
How do individual monosodium urate depositions respond to urate-lowering therapy? A systematic evaluation using the dual-energy CT modality. Rheumatology (Oxford). Published 6 August 2026. doi:10.
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