Journal List > J Korean Rheum Assoc > v.16(4) > 1003692

J Korean Rheum Assoc. 2009 Dec;16(4):318-322. Korean.
Published online December 31, 2009.
Copyright © 2009 The Korean Rheumatism Association
A Case of the Lumbar Spine Involvement and Sacroiliitis in a Patient with Gout
So-Young Bang,1 Jong Heon Jeong,1 Kyung Bin Joo,2 Jae-Bum Jun,1 and Yoon-Kyoung Sung1
1Department of Rheumatology, Hospital for Rheumatic Disease, Hanyang University College of Medicine, Seoul, Korea.
2Department of Radiology, Hanyang University College of Medicine, Seoul, Korea.

Corresponding author (Email: )
Received June 08, 2009; Revised August 18, 2009; Accepted August 21, 2009.


Although gout often initially affects the peripheral joints, gout may also involve the axial joints. The radiologic changes of axial gout are more common than are clinically recognized. According to a recent report, when the spine CT images of peripheral gout were reviewed for features of axial gout, there was about a 14% frequency of suspected axial gout. The vertebral level and the finding with the most common spinal gouty changes were L4 and lumbar facet joint erosions. We describe here the case of a 36-year-old gout patient with low back and right buttock pain and his lesions were unexpectedly diagnostic of lumbar facet joint arthritis and right sacroiliitis.

Keywords: Gout; Spine; Sacroiliac joint; Computed tomography; Magnetic resonance imaging


Fig. 1
The T1-weighted MRI shows low signal intensity on the right L5-S1 facet joint, bone, and soft tissue (A). T2-weighted MRI shows intermediate to high signal intensity on the right L5-S1 facet joint, bone, and soft tissue (B). The gadolinium enhanced T1-weighted MRI shows heterogenous enhancement of the right L5-S1 facet joint, bone, and soft tissue (C).
Click for larger image

Fig. 2
The CT scan shows bony erosions in the right L5-S1 facet joint on two consecutive images (A, B).
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Fig. 3
The gadolinium enhanced T1-weighted MRI shows heterogenous enhancement of the right sacrum, SI joint and ilium.
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Fig. 4
The coronal reformatted CT image of the SI joints show multiple, well-marginated erosions along the articular surfaces of the right SI joint (A, B).
Click for larger image

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