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Related Experiment Video

Updated: Sep 17, 2025

Addressing Practical Issues in Atomic Force Microscopy-Based Micro-Indentation on Human Articular Cartilage Explants
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Costal cartilage mimics urate on DECT.

Anthony J Doyle1,2, Michel K Nieuwoudt3, Jason Woon4

  • 1Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd Grafton, Auckland, 1023, New Zealand. a.doyle@auckland.ac.nz.

Skeletal Radiology
|July 4, 2025
PubMed
Summary

Dual-energy CT (DECT) can identify material in costal cartilages that appears similar to urate. However, this study confirms that the isoattenuating material is not urate and may be artifactual in clinical practice.

Keywords:
ArtefactCostal cartilageDual-energy CTGoutMimicUrate

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Area of Science:

  • Radiology
  • Biomedical Engineering
  • Materials Science

Background:

  • Dual-energy CT (DECT) is a valuable imaging technique for material characterization.
  • Distinguishing urate deposits from other calcifications is crucial for diagnosing conditions like gout.
  • Isoattenuating material in costal cartilages on DECT has been observed, but its composition remains unclear.

Purpose of the Study:

  • To determine if the isoattenuating material observed in costal cartilages on DECT is indeed urate.
  • To investigate the nature of this material and its implications for clinical diagnosis.

Main Methods:

  • Costal cartilage specimens from 12 cadavers were examined using DECT.
  • Specimens were stored in air, ethanol, and saline, with DECT scans performed before and after storage.
  • Cadaveric tophi served as positive controls, and storage fluids were analyzed for urate.
  • Raman spectroscopy was employed for material identification.

Main Results:

  • DECT revealed isoattenuating volumes in costal cartilages, which varied depending on storage conditions.
  • Storage in ethanol resulted in zero isoattenuating volumes, while storage in water led to a significant decrease over time.
  • Urate levels in costal cartilage storage fluid were zero, contrasting with high levels found in tophus storage fluid.
  • Raman spectroscopy confirmed the absence of urate in the costal cartilage specimens.

Conclusions:

  • The material in costal cartilages that appears isoattenuating to urate on DECT is not urate.
  • This material can simulate the attenuation profile of urate under specific conditions.
  • Clinically, isoattenuating material in costal cartilages on DECT should be considered artifactual.