To the Editor:
Gout (monosodium urate crystal deposition disease) has been estimated to affect 3 to 6 million Americans, and both the incidence and prevalence appear to be increasing1. Gout is characterized by serum urate supersaturation, extracellular tissue deposition of urate crystals in and around joints, and acute inflammatory episodes. In unusual cases, patients may present with tophaceous deposits in the absence of, or prior to, development of gouty arthritis2. Although acute gout typically affects peripheral joints, involvement of the axial skeleton has been recognized3. Dual-energy computed tomography (DECT) is a technique that is able to identify tophaceous deposits, which have a distinctive appearance. We describe a case of gouty lumbar facet arthritis utilizing DECT.
An 82-year-old Caucasian man with a history of obesity, type 2 diabetes, ischemic cardiomyopathy, atrial fibrillation, and chronic kidney disease presented with a complaint of acute on chronic low back pain. The back pain had increased significantly over the previous year, with …
Address correspondence to Dr. Calamia; E-mail: calamia.kenneth{at}mayo.edu