Of course, we can do gout
55 year old male presents to the ED for a foot ulcer. He has an aversion to medical care, has not seen a doctor for years, and does not take any medications. On physical exam, a large ulcer overlies the first MTP joint. CT scan was performed, showing extensive erosive arthritis and multiple soft tissue tophi.
Material decomposition with spectral CT can identify composition of tophi. In this case, urate deposition was confirmed. Identifying tissue composition is one of the most elegant uses of spectral CT. Used in this way, many more deposits of uric acid can be identified.
A long-standing history of untreated gout was elicited.