The utility of dual energy computed tomography in the management of axial gout: case reports and literature review

Jeremy X Wang; Beverly Ng; Haesung Bak; David Spencer; Nicholas Manolios; Peter K K Wong

doi:10.1186/s41927-020-00119-6

The utility of dual energy computed tomography in the management of axial gout: case reports and literature review

BMC Rheumatol. 2020 May 8:4:22. doi: 10.1186/s41927-020-00119-6. eCollection 2020.

Authors

Jeremy X Wang¹, Beverly Ng¹, Haesung Bak¹, David Spencer^{1

2}, Nicholas Manolios^{1

2}, Peter K K Wong^{1

3}

Affiliations

¹ 1Department of Rheumatology, Westmead Hospital, Westmead, Sydney, NSW 2145 Australia.
² 2Sydney Medical School, University of Sydney, Sydney, NSW Australia.
³ 3Rural Clinical School, Coffs Harbour, Faculty of Medicine, University of New South Wales, Sydney, Australia.

Abstract

Background: Severe spinal pain is an unusual presentation of gout. Due to its rarity and the difficulty of obtaining joint fluid or tissue for crystal analysis, dual energy computed tomography (DECT) may be a useful imaging modality in the management of axial gout.

Case presentation: Two patients independently presented to a major teaching hospital with severe spinal pain subsequently shown to be due to gout. The first patient presented with back pain and fevers and was initially thought to have lumbar facet joint septic arthritis. The second case presented with severe back pain. In both cases, DECT suggested monosodium urate deposition in spinal tissues as the cause of their presentation.

Conclusions: Axial gout should be considered in the differential diagnosis of severe spinal pain. A DECT study may be a useful diagnostic tool in the management of spinal gout.

Keywords: Back pain; Diagnosis; Dual energy computed tomography; Spinal gout.

Publication types

Case Reports