Mapping MSU crystal deposition within MTP joints in tophaceous gout: a dual-energy CT study
Authors' conclusion
In people with tophaceous gout, MSU crystal deposition is unevenly distributed. There is marked variation in sites of deposition not only between different MTP joints, but also within these joints.
Study context
- Population
- People with tophaceous gout; bilateral foot dual-energy CT (DECT) of MTP joints9,696 sites scored
- Participants
- 119 people
- Outcome
- Distribution of MSU crystal deposition within the MTP joints (quadrants of metatarsal head and phalangeal base)
Methodological detailsdual-energy CT, two independent readers, general estimating equations
- Dual-energy CT
- Two independent readers
- General estimating equations
Main finding
As reported in the abstract
MSU crystal deposition by site
- Medial quadrant of first metatarsal head (most frequent)
- 60%
- Plantar quadrants of first and second metatarsal heads and medial quadrant of first phalangeal base
- >30%
- Lateral quadrants of phalangeal bases of third and fourth MTP joints (rarely affected)
- 1%
- More deposition at first MTP joint vs other joints
- P < 0.0001
- More deposition at metatarsal head vs phalangeal base
- P < 0.0001
- More deposition at plantar and medial quadrants vs other quadrants
- P < 0.0001
Observational data: associations, not effects.
Original publication
Mapping MSU crystal deposition within MTP joints in tophaceous gout: a dual-energy CT study. Rheumatology (Oxford). Published 24 June 2025. doi:10.
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