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Spondyloarthritis: a gouty display
Preetam Gongidi1, Shawn Gough-Fibkins
1Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA.
Journal of Radiology Case Reports
|April 4, 2012
Summary
This case study highlights an unusual presentation of gout affecting spinal joints, not just peripheral ones. Radiologic findings confirmed gouty arthritis mimicking other conditions.
Area of Science:
- Rheumatology
- Radiology
- Metabolic Diseases
Background:
- Gout is a common systemic metabolic disease primarily affecting peripheral joints.
- Unusual presentations can mimic other conditions, complicating diagnosis.
- Spinal joint involvement in gout is rare but documented.
Purpose of the Study:
- To report a unique case of gout affecting the facet and costovertebral joints of the thoracic and lumbar spine.
- To emphasize the importance of considering gout in the differential diagnosis of spinal joint pain and lesions.
- To review the epidemiology, clinical presentation, and diagnostic imaging of gout.
Main Methods:
- Case report of a 54-year-old male presenting with joint pain and difficulty ambulating.
- Diagnostic imaging included plain radiographs, MRI of the elbow, and CT scan of the spine.
- Laboratory work-up and differential diagnosis considerations for hyperparathyroidism were performed.
Main Results:
- Imaging revealed olecranon bursitis and elbow erosion, but CT demonstrated lytic lesions in spinal facet and costovertebral joints.
- Bilateral medullary nephrocalcinosis was also noted.
- Hand X-rays, initially considered for hyperparathyroidism, showed classic signs of gouty arthritis, confirming the diagnosis.
Conclusions:
- Gout can present atypically with involvement of axial skeletal joints, including the spine.
- Comprehensive imaging and consideration of gout in the differential diagnosis are crucial for accurate diagnosis.
- This case underscores the diverse clinical and radiological spectrum of gout.
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