European Journal of Rheumatology
Case based Review
Lower back pain as a manifestation of acute gouty sacroiliitis: Utilization of dual-energy computed tomography (DECT) in establishing a diagnosis

Lower back pain as a manifestation of acute gouty sacroiliitis: Utilization of dual-energy computed tomography (DECT) in establishing a diagnosis

1.

Division of Rheumatology, Department of Internal Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

2.

Department of Internal Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

3.

Division of Musculoskeletal Imaging, Department of Radiology, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

Eur J Rheumatol 2019; 6: 216-218
DOI: 10.5152/eurjrheum.2019.18097
Read: 294 Downloads: 115 Published: 16 October 2019

Gout is the most common inflammatory arthritis which initially presents as a monoarthritis that usually favours peripheral joints namely the 1st MTP. It was reported in the literature to rarely involve the axial joint, such as the sacroiliac joint, and often mimics seronegative spondyloarthritis (SpA). Gout is a male disease and after menopause the risk in females is equal to males. Previous reports describe male patients developing gout involving the SI joint. We report a lady with a history of gout presenting with acute onset lower back pain. MRI of the sacroiliac joints revealed unilateral sacroilitis. With the help of Dual- Energy Computed Tomography (DECT) which is a newer imaging technique, a diagnosis of gout involving the sacroiliac joint was established. Gout involving the sacroiliac joints is rare, however it should be considered in the differential diagnosis in patients with unilateral sacroilitis given the similarity in presentation to SpA. Utilization of newer imaging modalities including DECT can highly guide in establishing a diagnosis and providing the correct treatment.

 

Cite this article as: Namas R, Hegazin SB, Memişoğlu E, Abhay J. Lower back pain as a manifestation of acute gouty sacroiliitis: Utilization of dual-energy computed tomography (DECT) in establishing a diagnosis. Eur J Rheumatol 2019; 6(4): 216-8.

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ISSN2147-9720 EISSN 2148-4279