Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever

Gout is a common inflammatory arthritis that has a high prevalence worldwide. It is characterized by monosodium urate deposition, usually affecting the joints and soft tissue of the lower extremities. Urate deposition in the axial skeleton resulting in spinal gout is rare. However, it seems to be mo...

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Main Authors: Andres Cordova Sanchez, Maneesh Bisen, Farzam Khokhar, Adriana May, Jihad Ben Gabr
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2021/7976420
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author Andres Cordova Sanchez
Maneesh Bisen
Farzam Khokhar
Adriana May
Jihad Ben Gabr
author_facet Andres Cordova Sanchez
Maneesh Bisen
Farzam Khokhar
Adriana May
Jihad Ben Gabr
author_sort Andres Cordova Sanchez
collection DOAJ
description Gout is a common inflammatory arthritis that has a high prevalence worldwide. It is characterized by monosodium urate deposition, usually affecting the joints and soft tissue of the lower extremities. Urate deposition in the axial skeleton resulting in spinal gout is rare. However, it seems to be more prevalent than usually thought, largely because it is underdiagnosed. Imaging findings are, for the most part, nonspecific and often mimic infectious etiologies. Definitive diagnosis requires pathological examination. Thus, it can be easily missed. We present a 41-year-old male with a seven-year history of untreated gout who came in with severe back pain, fevers, and radiculopathy. He was initially diagnosed with vertebral osteomyelitis. However, after a biopsy, spinal gout was confirmed. Spinal gout can be misdiagnosed as vertebral osteomyelitis given the similarities in presentation and imaging findings. This case report highlights the importance of keeping spinal gout as a differential of vertebral osteomyelitis, especially in patients with long-standing or uncontrolled gout with tophi.
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spelling doaj-art-52a33f41047349eeaf0dfd8a8dfcf7aa2025-02-03T01:27:06ZengWileyCase Reports in Rheumatology2090-68892090-68972021-01-01202110.1155/2021/79764207976420Diagnosing Spinal Gout: A Rare Case of Back Pain and FeverAndres Cordova Sanchez0Maneesh Bisen1Farzam Khokhar2Adriana May3Jihad Ben Gabr4Department of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USADepartment of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USADepartment of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USADepartment of Pathology, SUNY Upstate Medical University, Syracuse, NY 13210, USADivision of Rheumatology, SUNY Upstate Medical University, Syracuse, NY 13210, USAGout is a common inflammatory arthritis that has a high prevalence worldwide. It is characterized by monosodium urate deposition, usually affecting the joints and soft tissue of the lower extremities. Urate deposition in the axial skeleton resulting in spinal gout is rare. However, it seems to be more prevalent than usually thought, largely because it is underdiagnosed. Imaging findings are, for the most part, nonspecific and often mimic infectious etiologies. Definitive diagnosis requires pathological examination. Thus, it can be easily missed. We present a 41-year-old male with a seven-year history of untreated gout who came in with severe back pain, fevers, and radiculopathy. He was initially diagnosed with vertebral osteomyelitis. However, after a biopsy, spinal gout was confirmed. Spinal gout can be misdiagnosed as vertebral osteomyelitis given the similarities in presentation and imaging findings. This case report highlights the importance of keeping spinal gout as a differential of vertebral osteomyelitis, especially in patients with long-standing or uncontrolled gout with tophi.http://dx.doi.org/10.1155/2021/7976420
spellingShingle Andres Cordova Sanchez
Maneesh Bisen
Farzam Khokhar
Adriana May
Jihad Ben Gabr
Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
Case Reports in Rheumatology
title Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
title_full Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
title_fullStr Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
title_full_unstemmed Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
title_short Diagnosing Spinal Gout: A Rare Case of Back Pain and Fever
title_sort diagnosing spinal gout a rare case of back pain and fever
url http://dx.doi.org/10.1155/2021/7976420
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