Maarten van der Linden et al. of the NLRP3 inflammasome is enhanced in lupus neutrophils for NETosis. Arthritis Rheumatol macrophages. J Immunol 2013;190:121726. 2016;68:46272. 19 Rother N, Pieterse E, Lubbers J, Hilbrands L, van der Vlag 21 Lood C, Blanco LP, Purmalek MM et al. Neutrophil J. Acetylated histones in apoptotic microparticles drive extracellular traps enriched in oxidized mitochondrial DNA the formation of neutrophil extracellular traps in active are interferogenic and contribute to lupus-like disease. Nat lupus nephritis. Front Immunol 2017;8:1136. Med 2016;22:14653. 20 Dieker J, Tel J, Pieterse E et al. Circulating apoptotic 22 van der Linden M, Meyaard L. Fine-tuning neutrophil ac- microparticles in systemic lupus erythematosus patients tivation: strategies and consequences. Immunol Lett drive the activation of dendritic cell subsets and prime 2016;178:39. Rheumatology 2018;57:1234 doi:10.1093/rheumatology/key019 Clinical vignette Advance Access publication 21 February 2018 FIG.1 DECT scan of the left knee according to position- Gout misdiagnosis due to dual-energy computed ing of the right prosthetic knee tomography artefact A dual-energy CT (DECT) gout protocol (Fig. 1A) was performed for suspicion of gout of the left knee arthritis in 74-year-old woman with no monosodium urate crystals on initial SF analysis. DECT reconstructions revealed uric acid deposition automatically coloured in green (Fig. 1B, arrows) at the posterior surface of the femoral condyles. However, the localization of crystals deposition was unusual and the arthritis was not improved by colchicine. A new DECT was performed with flexion of the contralateral prosthetic knee (Fig. 1C) and did not show any green pixilation suggestive of gout, thus confirming a metal artefact due to the presence of the knee prosthesis (Fig. 1D). DECT is a valuable, non-inva- sive imaging modality for the diagnosis of gout when urate crystals confirmation in SF is not possible . However, DECT artefacts may lead to a false-positive diagnosis , mainly due to skin or beam-hardening artefacts such as in this first described case of DECT metal artefact due to contralateral knee prosthesis. Funding: No specific funding was received from any Coronal DECT reconstructions of a 74-year-old woman bodies in the public, commercial or not-for-profit sectors with left knee arthritis: beam-hardening artefact with to carry out the work described in this article. green pixilation suggestive of gout (arrows) at the pos- terior surface of the left femoral condyles disappears Disclosure statement: The authors have declared no when the contralateral prosthetic knee is flexed. conflicts of interest. References 1 2,3 Andre Ramon , Pierre Pottecher and 1,4 Paul Ornetti 1 Neogi T, Jansen TL, Dalbeth N et al. 2015 Gout classifi- 1 2 cation criteria: an American College of Rheumatology/ Department of Rheumatology, Department of Radiology, Section of Musculoskeletal Imaging and Intervention, Dijon University Hospital, European League Against Rheumatism collaborative LE2I UMR CNRS 6306, Arts et Metiers, University of Burgundy and initiative. Arthritis Rheumatol 2015;67:255768. INSERM 1093 CAPS, University of Burgundy, Dijon, France 2 Mallinson PI, Coupal T, Reisinger C et al. Artifacts in dual- Correspondence to: Paul Ornetti, Department of Rheumatol- energy CT gout protocol: a review of 50 suspected cases ogy, 14 rue Gaffarel, CHU Dijon, 21000 Dijon, France. with an artifact identification guide. Am J Roentgenol E-mail: firstname.lastname@example.org 2014;203:1039. The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: email@example.com 1234 https://academic.oup.com/rheumatology Downloaded from https://academic.oup.com/rheumatology/article-abstract/57/7/1234/4898125 by Ed 'DeepDyve' Gillespie user on 26 June 2018
Rheumatology – Oxford University Press
Published: Feb 21, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera