Abstract
BackgroundSevere spinal pain is an unusual presentation of gout. Due to its rarity and the difficulty of obtaining joint fluid or tissue for crystal analysis, dual energy computed tomography (DECT) may be a useful imaging modality in the management of axial gout.Case presentationTwo patients independently presented to a major teaching hospital with severe spinal pain subsequently shown to be due to gout. The first patient presented with back pain and fevers and was initially thought to have lumbar facet joint septic arthritis. The second case presented with severe back pain. In both cases, DECT suggested monosodium urate deposition in spinal tissues as the cause of their presentation.ConclusionsAxial gout should be considered in the differential diagnosis of severe spinal pain. A DECT study may be a useful diagnostic tool in the management of spinal gout.
Highlights
Severe spinal pain is an unusual presentation of gout
Gout is caused by monosodium urate (MSU) crystal deposition in synovial joints and is the most common acute inflammatory arthritis [1]
We present two cases of gout involving the axial skeleton in which dual energy computed tomography (DECT) significantly assisted management
Summary
Severe spinal pain is an unusual presentation of gout. Due to its rarity and the difficulty of obtaining joint fluid or tissue for crystal analysis, dual energy computed tomography (DECT) may be a useful imaging modality in the management of axial gout. Background Gout is caused by monosodium urate (MSU) crystal deposition in synovial joints and is the most common acute inflammatory arthritis [1]. We present two cases of gout involving the axial skeleton in which DECT significantly assisted management.
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