Gout With Tophus Mimicking a Tumor of the Thoracic Spine

Сороцкая, В. Н.; Елисеев, М. С.

doi:10.14412/1995-4484-2018-113-116

rsp

2018

DOI: 10.14412/1995-4484-2018-113-116

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Gout With Tophus Mimicking a Tumor of the Thoracic Spine

В. Н. Сороцкая¹,

М. С. Елисеев²

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2024

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Cited by 3 publications

References 13 publications

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Spinal involvement in gout simulating spondyloarthritis (clinical case)

Kuzmina,

Eliseev

2024

Sovremennaâ revmatologiâ

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The article presents a case of the lumbar spine involvement in a 37-year-old patient with gout who was observed for several years with a diagnosis of spondyloarthritis. Spinal involvement in the context of gout was confirmed by dual-energy computed tomography. This is a relatively new method for the diagnosis of microcrystalline arthritis, which makes it possible to detect urate deposits in the atypical course of the disease, especially when the axial skeleton is affected. We demonstrate the advantages of the modern gout treatment strategy of achieving and maintaining target uric acid levels by prescribing appropriate doses of xanthine oxidase inhibitors (febuxostat at a dose of 120 mg/day) while preventing arthritis flares (low-dose colchicine).

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Spinal involvement in gout simulating spondyloarthritis (clinical case)

Kuzmina,

Eliseev

2024

Sovremennaâ revmatologiâ

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Analysis of experience in the clinical use of dual-energy computed tomography in patients with undifferentiated arthritis

Eliseev,

Kuzmina

2024

Medicinskij alfavit

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Dual-energy computed tomography (DECT) is a radiation diagnostic method that is used in rheumatology to verify microcrystalline arthritis, but in Russia this method is little known and the experience of its use is rather scarce.Objective of the research. To analyze the experience of using DECT in patients with undifferentiated arthritis and lesions of the axial skeleton in clinical practice.Material and Methods. The retrospective study included 20 patients (14 men and 6 women) observed at the V. A. Nasonova Research Institute of Rheumatology, who underwent DECT for diagnostic purposes. 13 patients with undifferentiated arthritis underwent DECT of peripheral joints to diagnose gout; 7 patients with an established diagnosis of gout (based on the 2015 ACR/EULAR classification criteria for gout) – to clarify the genesis of lesions to the axial joints and spine. The study was performed on a Siemens SOMATOM Definition Flash computed tomograph.Results. Using DECT in patients with undifferentiated arthritis, deposits of monosodium urate crystals (MSUc) were detected in 7 out of 13 (54 %), which made it possible to verify the diagnosis of gout. In the second sample, 6 out of 7 patients (85 %) showed signs of MSUc deposition on DECT, which explained the genesis of the existing complaints. Among these 6 patients, in 1 person, DECT revealed the presence of MSUc and calcium pyrophosphate crystals in the shoulder joint, which made it possible to make two diagnoses at once – gout and calcium pyrophosphate deposition disease.Conclusion. DECT in patients with undifferentiated arthritis makes it possible to verify the diagnosis of gout in more than half of the cases (54 %). In 85 % of patients with gout and pain in the back and axial joints of unknown origin, urate deposits are detected according to DECT. This method may be a useful tool for identifying microcrystalline arthritis of the axial joints, but further research is needed to implement the method in routine practice.

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Sacroiliitis in gout: Difficulties of diagnosis

Agafonova,

Aristova,

Eliseev

et al. 2024

Naučno-praktičeskaâ revmatologiâ

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Gout is the most common chronic autoinflammatory disease, the development of which is associated with persistent hyperuricemia caused by both environmental and genetic factors, which leads to the deposition of sodium monourate crystals in various tissues and organs of the human body. Gout is more common in men than in women of childbearing age, due to the uricosuric effect of estrogen, however, after menopause, the incidence of gout in women increases significantly. At the onset of the disease, the first metatarsophalangeal joint, ankle and knee joints are most often involved in the pathological process. However, there are isolated reports in the literature about a rare gout lesion of the axial skeleton, for example, the sacroiliac joint, in which the nature of the pain syndrome, magnetic resonance imaging, and X-ray picture can mimic spondyloarthritis. The article presents a rare case of damage to the axial skeleton in a 57-year-old patient with gout, manifested by acute inflammatory back pain and arthritis of the lower extremities.

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Gout With Tophus Mimicking a Tumor of the Thoracic Spine

Cited by 3 publications

References 13 publications

Spinal involvement in gout simulating spondyloarthritis (clinical case)

Spinal involvement in gout simulating spondyloarthritis (clinical case)

Analysis of experience in the clinical use of dual-energy computed tomography in patients with undifferentiated arthritis

Sacroiliitis in gout: Difficulties of diagnosis

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