Gout in the Spine: Imaging, Diagnosis, and Outcomes.
Gout is characterized by the deposition of monosodium urate crystals and by acute and chronic inflammation in response to crystals so deposited. Multiple case reports and series describe the deposition of monosodium urate in the spine as a rare manifestation of gout, but the actual prevalence of spinal involvement is unknown and likely to be higher than generally anticipated. Here we review the characteristics of 131 previously reported cases of spinal involvement in gout. We focus in particular on the use of imaging modalities and the extent to which they correlate with presenting symptoms and tissue diagnoses. The recent innovation of using dual-energy computerized tomography to identify urate crystal deposition holds promise for reducing the need for surgical intervention and for establishing a true prevalence rate for spinal gout.
Division of Rheumatology, Department of Medicine, NYU School of Medicine/NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA.|Rheumatology Section, Department of Medicine, VA New York Harbor Health Care System, New York Campus, New York, NY, 10010, USA.
Michael
M
Toprover
Division of Rheumatology, Department of Medicine, NYU School of Medicine/NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA.|Rheumatology Section, Department of Medicine, VA New York Harbor Health Care System, New York Campus, New York, NY, 10010, USA.
Svetlana
S
Krasnokutsky
Division of Rheumatology, Department of Medicine, NYU School of Medicine/NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA. Michael.Pillinger@nyumc.org.|Rheumatology Section, Department of Medicine, VA New York Harbor Health Care System, New York Campus, New York, NY, 10010, USA. Michael.Pillinger@nyumc.org.
Michael H
MH
Pillinger
D001416:Back Pain / Q000209:etiology; D006073:Gout / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D025241:Spondylarthritis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
Back pain; DECT; Dual-energy CT; Gout; Spine; Tophus