Gout typically
affects the 1st
metatarsophalangeal joint. Spinal
gout is rarely reported. Moreover, involvement of extensive spines is remarkably unusual. We describe a case of a 76-year-old
woman with
gout involving cervical, thoracic, and lumbar spines and
sacroiliac joint. She presented with
fever, severe
back pain, and
polyarthralgia and had multiple tophi on both elbows and the left 2nd and 5th proximal interphalangeal (PIP)
joints.
Monosodium urate crystals were confirmed from tophi on the left 5th PIP
joint by polarized
optical microscopy.
Magnetic resonance imaging and computed
tomography showed
joint space narrowing and bony erosions on cervical, thoracic, and lumbar spines, and
sacroiliac joint.
Fever,
back pain, and
polyarthralgia improved significantly with oral
steroid therapy. Spinal
gout can involve multiple spines and other
joints and it can be improved by medical
treatment only. It should be considered in
patients with uncontrolled
gout who have acute severe
back pain.