Presentation
Declining hand function and increasing deformity.
Patient Data
There is joint space narrowing predominately involving the proximal interphalangeal joints with associated peri-articular lytic lesions. This is most marked at the second metacarpophalangeal joint of the left hand. Erosions are also seen within the carpal bones. Soft tissue calcification surrounds the left second MCP joint.
LEFT: There are green pixels in radiocarpal, ulnocarpal, 1st carpometacarpal, 2nd metacarpophalangeal joints. Crystal deposits are seen in relation to 3rd extensor compartment and flexor digitorum longus to the 5th finger.
RIGHT: There are green pixels related to radiocarpal, ulnocarpal, intercarpal, 1st carpometacarpal, 2nd and 5th metacarpophalangeal, and the 3rd proximal interphalangeal joints.
Case Discussion
Appearance on the dual energy CT is in keeping with bilateral gouty arthritis.
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