J Korean Rheum Assoc.  2009 Dec;16(4):318-322.

A Case of the Lumbar Spine Involvement and Sacroiliitis in a Patient with Gout

• Bang SY
• Jeong JH
• Joo KB
• Jun JB
• Sung YK

Abstract

Although gout often initially affects the peripheral joints, gout may also involve the axial joints. The radiologic changes of axial gout are more common than are clinically recognized. According to a recent report, when the spine CT images of peripheral gout were reviewed for features of axial gout, there was about a 14% frequency of suspected axial gout. The vertebral level and the finding with the most common spinal gouty changes were L4 and lumbar facet joint erosions. We describe here the case of a 36-year-old gout patient with low back and right buttock pain and his lesions were unexpectedly diagnostic of lumbar facet joint arthritis and right sacroiliitis.

Keyword

Gout; Spine; Sacroiliac joint; Computed tomography; Magnetic resonance imaging

MeSH Terms

Adult
Arthritis
Buttocks
Gout
Humans
Joints
Magnetic Resonance Imaging
Sacroiliac Joint
Sacroiliitis
Spine
Zygapophyseal Joint

Figure

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  Fig. 1. The T1-weighted MRI shows low signal intensity on the right L5-S1 facet joint, bone, and soft tissue (A). T2-weighted MRI shows intermediate to high signal intensity on the right L5-S1 facet joint, bone, and soft tissue (B). The gadolinium enhanced T1-weighted MRI shows heterogenous enhancement of the right L5-S1 facet joint, bone, and soft tissue (C).

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  Fig. 2. The CT scan shows bony erosions in the right L5-S1 facet joint on two consecutive images (A, B).

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  Fig. 3. The gadolinium enhanced T1-weighted MRI shows heterogenous enhancement of the right sacrum, SI joint and ilium.

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  Fig. 4. The coronal reformatted CT image of the SI joints show multiple, well-marginated erosions along the articular surfaces of the right SI joint (A, B).

Reference

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