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Gout mimicking spondyloarthritis: case report and literature review

Authors Chen W, Wang Y, Li Y, Zhao Z, Feng L, Zhu J, Zhang J, Huang F

Received 31 January 2017

Accepted for publication 10 May 2017

Published 29 June 2017 Volume 2017:10 Pages 1511—1514

DOI https://doi.org/10.2147/JPR.S133572

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Katherine Hanlon

Wenji Chen,1 Yanyan Wang,2 Yan Li,2 Zheng Zhao,2 Lixia Feng,2 Jian Zhu,2 Jianglin Zhang,2 Feng Huang2

1Department of Rheumatology, Hainan Branch of Chinese People’s Liberation Army General Hospital, Sanya, 2Department of Rheumatology, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China


Abstract:
Gout is clinically characterized by episodes of monoarthritis, which not only typically affects the peripheral joints but also occasionally affect the axial joint, such as the sacroiliac joint (SIJ), and often mimics spondyloarthritis (SpA). Two cases of gout mimicking SpA are presented in the current paper. One patient was a 32-year-old man with a history of asymmetrical oligoarthritis of ankle and metatarsophalangeal joints (MTPJ). He had left gluteal pain for 2 weeks. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the bone erosion of the left SIJ. T1-weighted MRI showed hypointense T1 and hyperintense T2 signals of the left SIJ. The other patient was a 24-year-old man with left back pain and hip pain for 4 months and intermittent fever for 3 months. He had a history of gout for 3 years. Both patients underwent CT-guided sacroiliac biopsy, and monosodium urate (MSU) crystals were shown by polarized microscopy. Gout can often mimic SpA and seldomly affects the SIJ. Thus, its correct diagnosis and adequate therapy can halt the development of such damaging complications.

Keywords: gout, crystal arthropathy, sacroiliac joint, radiography

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