[Predictive value of urate deposition volume for refractory gout development in gout patients]

To analyze deposition of sodium urate in patients with gout, and to explore predictive value of sodium urate deposition for the occurrence of refractory gout (RG) by dual-energy CT imaging technique.

A retrospective analysis was conducted on basic data of 176 gout patients admitted from March 2023 to June 2025, including 171 males and 5 females, aged from 22 to 71 years old with an average of(43.16±10.82) years old. According to diagnostic criteria, the patients were divided into RG group and non-RG group. There were 92 patients in RG group, including 90 males and 2 females, aged from 24 to 66 years old with an average of (44.62±11.12) years old;there were 84 patients in non-RG group, including 81 males and 3 females, aged from 22 to 71 years old with an average of (41.46±10.31) years old. The courses of hyperuricemia, uric acid and deposition amounts of monosodium urate(MSU) between two groups were compared. Multivariate Logistic regression was used to analyze influencing factors of RG, receiver operating curve (ROC) was plotted, and area under the curve(AUC) was calculated, in order to evaluate predictive value of MSU deposition for RG.

The courses of hypertension and hyperuricemia and deposition amount of MSU between two groups were statistically significant (P<0.05). Logistic analysis reault showed intra-articular MSU deposition[OR=5.402, 95%CI(2.095, 13.933), P<0.01], hypertension[OR=2.724, 95%CI(1.209, 6.134), P<0.05], courses of hyperuricemia [OR=1.122, 95%CI(1.032, 1.219), P<0.01] were independent risk factors for RG. AUC of MSU deposition for predicting RG was 0.824[95%CI(0.763, 0.885), P<0.01], and sensitivity was 63%, specificity was 92.9%, and the optimal cut-off value was 0.410 cm³.

MSU deposition could increase risk of RG, and the amount of MSU deposition in joint cavity could provide a reference for early identification of patients with RG.