Looking Back

Axial crystal arthropathy mimicking facet joint septic arthritis with epidural abscess

“…8 In some cases diagnosis has only been made retrospectively following relapse of symptoms. 10 It is likely that the prevalence of axial crystal disease is much higher than currently reported, with most cases unrecognised.…”

“…9 Case reports have found that DECT can be useful in the diagnosis of spinal gout, but, as with peripheral disease, a negative scan does not exclude gout. 7,9,10 The utility of DECT in CPPD is still under investigation, with early reports suggesting it is less reliable than in MSU detection. 7 In this case, DECT was performed after the operation following the excision of tophaceous material, six weeks of oral prednisolone and complete resolution of axial symptoms, potentially limiting the yield.…”

“…The sensitivity of DECT increases with chronicity of gout with a range of 71–97% and specificity of 84–95% 9 . Case reports have found that DECT can be useful in the diagnosis of spinal gout, but, as with peripheral disease, a negative scan does not exclude gout 7,9,10 . The utility of DECT in CPPD is still under investigation, with early reports suggesting it is less reliable than in MSU detection 7 .…”

“…To date, diagnosis of axial crystal disease has primarily occurred only in those requiring surgical decompression 8 . In some cases diagnosis has only been made retrospectively following relapse of symptoms 10 . It is likely that the prevalence of axial crystal disease is much higher than currently reported, with most cases unrecognised.…”