Abstract
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.
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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).
![jkra-16-318f1.tif](/upload/SynapseXML/0010jkra/thumb/jkra-16-318f1.gif)
Fig. 2.
The CT scan shows bony erosions in the right L5-S1 facet joint on two consecutive images (A, B).
![jkra-16-318f2.tif](/upload/SynapseXML/0010jkra/thumb/jkra-16-318f2.gif)