Posted on November 23, 2011
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X-ray images known as CT scans can help confirm gout in patients who are suspected of having the painful condition but receive negative results from traditional tests, a Mayo Clinic study has found. The type of CT scan analyzed, dual-energy computed tomography, is also valuable for diagnosing people who cannot be tested with the typical method of drawing fluid from joints, researchers found. The study is being presented at the American College of Rheumatology annual scientific meeting in Chicago.
Gout – the buildup of uric acid crystals in and around joints, causing inflammation and painful, potentially disabling flare-ups – has historically been portrayed as a disease of the wealthy, but it afflicts people from all walks of life. Men are likelier to develop gout, but women’s risk rises after menopause, when their uric acid levels approach those of men. Treatment usually involves medication and dietary changes.
Physicians traditionally check for gout by using a needle to draw fluid from affected joints and examining the fluid for uric acid crystals. Dual-energy CT scans were recently modified to detect the crystals, and the study found the scans “very accurate” in identifying patients with gout, says lead researcher Tim Bongartz, M.D., a rheumatologist at Mayo Clinic in Rochester, Minn.
“We wanted to really challenge the new method by including patients who were only a few days into their first flare of gout,” Dr. Bongartz says.
Dr. Bongartz notes that CT scans are significantly more expensive than the standard test for diagnosing gout. He also cautions that, while highly accurate overall, in one subgroup of patients studied – those with very acute gout – the CT scan failed to identify 30 percent of cases. The new tool is most helpful when joint fluid cannot be obtained or the fluid analysis comes back negative even when gout is strongly suspected, he says.
Experts from Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University are available for interviews on topics ranging from effects of radiation dose and exposure to MRI imaging to detect brain damage in soccer players due to “heading” and cancer post-treatment imaging during the annual Radiological Society of North America Scientific Assembly.
DIAGNOSTIC RADIOLOGY AND RADIATION DOSE
Stephen Amis, MD Chair, Department of Radiology at Montefiore Medical Center and Professor of Radiology at Albert Einstein College of Medicine
Stephen Amis, MD, Chair, Department of Radiology at Montefiore Medical Center and Professor of Radiology at Albert Einstein College of Medicine, is a nationally renowned leader in the field of urology and diagnostic radiology. He is a past president of the American College of Radiology and a board member of the National Council for Radiation Protection and Measurement (NCRP). As a co-author on a white paper on “Radiation Dose in Medicine” that was published in the Journal of the American College of Radiology in 2007, he has been quoted widely about the effects of radiation dose and exposure, radiation protection and error prevention.
WHITE MATTER INJURY DUE TO SOCCER HEADING
Michael L. Lipton, MD, PhD, Medical Director of MRI services at Montefiore Medical Center and Associate Professor of Radiology, Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine
Michael Lipton, MD, PhD, Medical Director of MRI services at Montefiore Medical Center and Associate Professor of Radiology, Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, is presenting a scientific paper entitled, “Making Soccer Safer for the Brain: DTI-defined Exposure Thresholds for White Matter Injury Due to Soccer Heading,” under embargo until Tuesday, November 29 at 12:01AM. His areas of interest include subtle brain injury to predict cognitive outcome, the brain substrates of mental illness, integrated multi-modal imaging for surgical management of brain tumors, the aging brain and proactive approaches to maximize safe use of MRI.
Xiaobo Li, Ph.D., Assistant Professor of Radiology at Albert Einstein College of Medicine and Montefiore Medical Center is presenting under the title, “Disturbed Brain Activity and Functional Connectivity during Visual Attention Working Memory Task in Attention Deficit/Hyperactivity Disorder,” under embargo until Monday November 28, 2011 at 12:01 AM (LL-PDS-SU1A).
Netta M. Blitman, MD, Director, Division of Pediatric Radiology, Department of Radiology, Montefiore Medical Center and Associate Professor at Albert Einstein College of Medicine, is presenting a scientific paper entitled, “Value of Focused Appendicitis Ultrasound and Alvarado Score in the Diagnosis of Appendicitis in Children: Can We Reduce the Use of CT Scans?” under embargo until Wednesday November 30, 2011 at 10:50 AM (SSK14-03).
Robert J. Dym, MD, an Assistant Professor in the Department or Radiology at Albert Einstein College of Medicine and Montefiore Medical Center, will present a scientific paper on the topic of “Appropriateness of Imaging Studies Ordered by Emergency Medicine Residents: Results of an Online Survey,” on Tuesday November 29, 2011 at 8:55 AM (MSVE31-02). Dr. Dym will also present an exhibit entitled “Air Apparent: Mimics of Gastrointestinal Perforation on Plain Films,” on Wednesday November 30, 2011 (LL-GIE1331-WEA).
Marjorie W. Stein, MD, Associate Professor for Radiology at Albert Einstein College of Medicine and Montefiore Medical Center, is an expert in ultrasound and will present an exhibit entitled, “Outside the Inside: A Review of Soft Tissue Abnormalities Seen on CT of the Abdomen and Pelvis,” under embargo until Sunday November 27, 2011 at 8AM (LL-MSE2218).
Keivan Shifteh, MD, Director of Head & Neck Imaging at Montefiore Medical Center and Associate Professor of Clinical Radiology at Albert Einstein College of Medicine, studies patients with mild head trauma, pediatric patients with obstructive sleep apnea and patients with head & neck cancer. Dr. Shifteh will participate in exhibits including “Common and Uncommon Lesions of the Parotid Space: Anatomy, Histology, and Routes of spread,” under embargo until Sunday November 27, 2011 at 8AM (LL-NRE4202) and “Post-treatment Imaging in Head and Neck Cancer,” under embargo until Monday, November 28, 2011 at 12:45 PM (LL-NRE-MO13B). Dr. Shifteh is available for comment on topics including head and neck, brain, spine, diagnostic cerebral angiogram.
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