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Diagnosis is key to Relief of Baton Rouge Spinal Gout

July 25, 2023

Gout. If you’ve had gout, you know how uncomfortable it is. You may also know how tough it was to diagnose, particularly if it was in the spine. Back pain or leg pain might have been your first symptom. Your Baton Rouge chiropractor at Medical Spine and Sports Injury and Rehab Centers is aware of spinal gout, its similarities with other conditions’ symptoms, and the latest advised tests to diagnose it sooner than later to help you get the (proper!) care you need.

PREVALENCE OF SPINAL GOUT

Arthritis is an inflammatory condition impacting people around the world - 47.8 million US sufferers, 8 million UK sufferers, 108 million European sufferers - with osteoarthritis being the most common affecting joints in the knee, hands, etc. Gout is just such an inflammatory cause of pain in similar areas, making it challenging to diagnose and discrimainate from other inflammatory issues. (1) A recent narrative review reported that 94% of spinal gout patients experienced back or neck pain, 86% showed neurological symptoms, 72% noted a history of gout, 80% had high levels of serum uric acid, and 76% underwent surgery. Though an uncommon cause of spine pain, gout’s inflammatory arthritis stems from monosodium urate crystals in synovial fluid and other joint tissues (ankle, foot, hands, wrists, elbows, knees, hips, and spine). (2) An early, appropriate diagnosis of spinal gout can better direct treatment and enhance clinical outcomes.

DIAGNOSIS OF SPINAL GOUT

Researchers have investigated various ways to safely and accurately identify gout in people who have never had gout. They have analyzed studies from as far back as 1945! They found that synovial fluid monosodium urate crystal analysis and imaging were better than a clinical algorithm of signs and symptoms only for diagnosis and treatment planning. (3) Facet joint disorders, osteoarthritis, synovial cysts, etc., can cloud the diagnostic process for spinal gout. Fortunately, dual energy computed tomography (DECT) shows the crystals. However, healthcare providers must be aware that gout is a possible cause to order the proper test. (4) A narrative review of published studies on spinal gout that was done by two chiropractors agreed. To make better the quality of life of spinal gout sufferers as well as the diagnosis, treatment planning and prevention of surgery, a combination of clinical symptoms, lab tests, and DECT may hold the answer. (2) Medical Spine and Sports Injury and Rehab Centers notes that cases of spinal gout are appearing in the medical literature.

CASES OF SPINAL GOUT and TREATMENT

One case of a 48-year-old man with sudden, severe, sharp low back pain that reduced his mobility and with no history of gout wound up with a diagnosis of spinal gout after an MRI showed a mass in his right erector spinae muscles which lead to a pathological exam revealed spinal gout. 29% of patients with gout have spinal gout, too, which didn’t help in this case of a patient without gout but is an interesting stat to consider in the next case. (5) A 41-year-old male who did have a 7-year history of gout presented with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed invalidating an initial diagnosis of vertebral osteomyelitis. Primary treatment often involves symptom management with colchicine, steroids, urate reducing therapy, and NSAIDS. (6) If spinal gout is suspected, Medical Spine and Sports Injury and Rehab Centers will get the right tests ordered.

CONTACT Medical Spine and Sports Injury and Rehab Centers

Listen to this PODCAST with Dr. Joseph Beissel on The Back Doctors Podcast with Dr. Michael Johnson as he illustrates the relief with The Cox® Technic System of Spinal Pain Management for chronic back pain.

Make your Baton Rouge chiropractic appointment soon. Your Baton Rouge chiropractor will do a complete examination to figure out the best course to appropriately diagnose, treat, and attain the best relief of spinal gout. 

Medical Spine and Sports Injury and Rehab Centers is aware that inflammatory spinal gout is a differential diagnosis to consider for patients who present with back pain and other spine related symptoms.