Axial Gout: Cinderella of Gouty Arthropathy!

Saketkoo, Lesley Ann; García-Valladares, Ignacio; Espinoza, Luis R.

doi:10.3899/jrheum.120375

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…Spinal gout was usually reported in men with chronic tophaceous gout in consequence of longstanding, poorly controlled gout. They usually had radiographic erosions or tophi in the hands or feet [2,5,6,12]. In our case, she was an also uncontrolled patient of chronic tophaceous gout diagnosed 14 years ago and had radiographic changes and tophi in both hands and feet.…”

Section: Discussionmentioning

confidence: 55%

Chronic Tophaceous Gout in Multiple Spines: A Case Report and Literature Review

et al. 2015

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Gout typically affects the 1st metatarsophalangeal joint. Spinal gout is rarely reported. Moreover, involvement of extensive spines is remarkably unusual. We describe a case of a 76-year-old woman with gout involving cervical, thoracic, and lumbar spines and sacroiliac joint. She presented with fever, severe back pain, and polyarthralgia and had multiple tophi on both elbows and the left 2nd and 5th proximal interphalangeal (PIP) joints. Monosodium urate crystals were confirmed from tophi on the left 5th PIP joint by polarized optical microscopy. Magnetic resonance imaging and computed tomography showed joint space narrowing and bony erosions on cervical, thoracic, and lumbar spines, and sacroiliac joint. Fever, back pain, and polyarthralgia improved significantly with oral steroid therapy. Spinal gout can involve multiple spines and other joints and it can be improved by medical treatment only. It should be considered in patients with uncontrolled gout who have acute severe back pain. (J Rheum Dis 2015;22:250-255)

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Section: Discussionmentioning

confidence: 55%

Chronic Tophaceous Gout in Multiple Spines: A Case Report and Literature Review

et al. 2015

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“…In addition, diabetes was associated with axial deposition in patients with gout. Several studies have investigated the clinical and the radiologic findings of axial gout (5)(6)(7)(8)(9)(10)17). The prevalence of axial gout is varied based on the design and the demographics of the study population, with a range of 14-35% in gout patients (7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

“…Although the demonstration of MSU crystals in tissue samples is the gold standard for diagnosing gout, previous studies suggested that CT is a useful imaging modality in the initial diagnosis of axial gout ( 5 , 7 – 10 , 18 ). Hongli et al raised a question on whether the gout-suggestive features on CT are specific for axial gout or gouty arthritis, especially for abnormal bony neoformations of the facet joints and intervertebral disk ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Gout is the most common inflammatory arthritis and is caused by an accumulation of monosodium urate (MSU) crystals in the synovial fluid ( 1 – 3 ). The MSU crystals accumulate in the synovial fluid and form deposits on the cartilage and, potentially, every tissue of the body, including the axial skeleton, where the facet joints, spinous processes, intervertebral disk, or sacroiliac joints may have MSU deposits ( 1 , 4 , 5 ). Gout typically involves the peripheral joints of the appendicular skeleton.…”

Section: Introductionmentioning

confidence: 99%

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The Frequency of Axial Deposition in Korean Patients With Gout at a Tertiary Spine Center

2020

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Objectives: This study aimed to describe the frequency of axial deposition (axial gout) and determine the associated factors in patients with gout who presented to a spine clinic in Korea. Methods: We enrolled 95 Korean patients who visited our spine center from March 2012 to February 2016 and who had been previously diagnosed with gout and had available computed tomography (CT) images of the vertebral columns. Axial gout was defined as the presence of erosions or tophi in the vertebral endplate or facet joint. The clinical and laboratory data of these patients were retrieved from medical records. Results: Out of 95 patients, 15 [15.8%; 95% confidence interval (CI), 9.4-25.0%] had a conventional CT evidence suggestive of axial gout. In these 15 patients, 12 (80%) had lumbar spine involvement (95% CI, 51.4-94.7%). Fifteen patients had erosions of the vertebral column, and two presented with tophi that exhibited erosive changes of the facet joints. The presence of axial gout was not associated with the patients' age, duration of gout, laboratory findings, inflammatory back pain symptoms, identification of monosodium urate crystals in the peripheral joints, current use of urate-lowering drugs, hypertension, and end-stage renal disease; however, there was a significant association with the presence of diabetes (P = 0.008). Conclusions: The frequency of axial deposition in Korean patients with gout and spinal symptoms was 15.8%, with the lumbar region being the most commonly involved section of the spine. In addition, diabetes was associated with evidence of axial gout on imaging.

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“…Other inflammatory disorders, including gout, Still's disease, and hemochromatosis, were initially considered for inclusion but not considered further due to their lack of clinical, familial aggregation. Gouty arthritis, including axial gout, may merit further investigation [4,5].…”

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confidence: 99%