Spinal gout diagnosis in chiropractic practice: narrative review

Area of Science:

• Rheumatology
• Spinal Health
• Diagnostic Imaging

Background:

• Gout is a common condition characterized by hyperuricemia and urate crystal deposition.
• Spinal involvement in gout is rare but can lead to significant morbidity.
• Chiropractic physicians require updated guidance on diagnosing spinal gout.

Purpose of the Study:

• To review and synthesize recent literature on spinal gout.
• To enhance awareness among chiropractic physicians regarding spinal gout diagnosis.
• To provide clinical guidance for managing spinal gout.

Main Methods:

• Systematic literature search of PubMed for case reports, reviews, and trials on spinal gout.
• Analysis of 38 reported cases of spinal gout.
• Evaluation of diagnostic modalities including clinical presentation, laboratory tests, and Dual Energy Computed Tomography (DECT).

Main Results:

• 94% of spinal gout patients experienced back or neck pain.
• 86% presented with neurological symptoms.
• 72% had a prior gout diagnosis, and 80% showed elevated serum uric acid.
• 76% of cases required surgical intervention.
• DECT shows promise for improving early diagnosis.

Conclusions:

• Spinal gout is an infrequent but critical consideration in the differential diagnosis of spinal pain.
• Increased awareness and earlier detection of spinal gout can enhance patient quality of life.
• Prompt diagnosis and treatment may reduce the necessity for surgical intervention.