Gouty Arthritis of the Axial Skeleton: A Case Report

Abstract

We present a case of a patient with systemic gout disease who did not receive any treatments for 10 years. A seventy-one-year-old male came to our attention for physical weariness, chest dis-comfort, a mild fever for more than a month and right knee pain. His blood test and laboratory data showed elevated white blood cell (WBC), uric acid (UA) and C-reactive protein (CRP). The bone scintigraphy showed increased radioactive tracer suggestive of multiple arthritis in-cluding axial skeleton. Whole body computed tomography (CT) scan showed multiple areas of bone erosion and tophi, especially in the sternoclavicular joints, sternocostal joints and facet joints of lumbar spine. Gouty arthritis typically affects the peripheral joints of the appendicular skeleton, especially feet and hands. Systemic gout disease affects not only the peripheral joints of the appendicular skeleton, but also the axial skeleton. Although joint aspiration is needed to detect monosodium urate (MSU) crystals, both scintigraphy and CT scan are powerful means to diagnose gouty arthritis at the same time.