{"title":"Spinal gout in gouty polyarthropathy.","authors":"Karel Mercken, Bjorn Valgaeren, Nathalie Noppe","doi":"10.1007/s00256-025-04983-6","DOIUrl":null,"url":null,"abstract":"<p><p>Gout is a crystal arthropathy and is the most common inflammatory arthritis in adults. Spinal involvement is observed in 17% of gout patients and may still be under-recognized. MRI is sensitive, but not specific, in identifying spinal gout, mainly due to varying signal characteristics of tophi and mimicking findings with infectious spondylodiscitis. In patients with a history of spinal surgery, distinguishing between spondylodiscitis and spinal gout on MRI becomes even more challenging. Dual-energy computed tomography (DECT) can help differentiate crystal arthropathies from infectious spondylodiscitis and regular degenerative osteoarthritis with high sensitivity and specificity by detecting monosodium urate crystals. This paper reports the case of an 80-year-old patient with lumbar back pain and a history of lumbar spine surgery. MRI revealed alterations suggestive of spondylodiscitis. Surgical biopsy results were negative for infection, but inconclusive for gout. The diagnosis of spinal gout was ultimately established using DECT in the context of polyarthropathy.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"2589-2595"},"PeriodicalIF":2.2000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skeletal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00256-025-04983-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/13 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Gout is a crystal arthropathy and is the most common inflammatory arthritis in adults. Spinal involvement is observed in 17% of gout patients and may still be under-recognized. MRI is sensitive, but not specific, in identifying spinal gout, mainly due to varying signal characteristics of tophi and mimicking findings with infectious spondylodiscitis. In patients with a history of spinal surgery, distinguishing between spondylodiscitis and spinal gout on MRI becomes even more challenging. Dual-energy computed tomography (DECT) can help differentiate crystal arthropathies from infectious spondylodiscitis and regular degenerative osteoarthritis with high sensitivity and specificity by detecting monosodium urate crystals. This paper reports the case of an 80-year-old patient with lumbar back pain and a history of lumbar spine surgery. MRI revealed alterations suggestive of spondylodiscitis. Surgical biopsy results were negative for infection, but inconclusive for gout. The diagnosis of spinal gout was ultimately established using DECT in the context of polyarthropathy.
期刊介绍：
Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration.
This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.
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