Diagnosis is key to Relief of La Grande Spinal Gout
Gout. If you have had gout, you know how uncomfortable it is. You may also know how difficult it was to identify as the issue, especially if it was in the spine. Back pain or leg pain might have been your first symptom. Your La Grande chiropractor at Dr. Paulette Hugulet, DC, LLC understands spinal gout, its similarities with other conditions’ symptoms, and the latest recommended assessments to diagnose it early to direct you to the (appropriate!) 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 tough to diagnose and differentiate from other inflammatory issues. (1) A recent narrative review reported that 94% of spinal gout patients described back or neck pain, 86% showed neurological symptoms, 72% had a history of gout, 80% had high levels of serum uric acid, and 76% underwent surgery. Though an infrequent cause of spine pain, gout’s inflammatory arthritis results from monosodium urate crystals in synovial fluid and other joint tissues (ankle, foot, hands, wrists, elbows, knees, hips, and spine). (2) An early, suitable diagnosis of spinal gout can better guide treatment and improve clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated a variety of ways to safely and accurately diagnose gout in people who have never experienced gout. They have reviewed 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 confuse the diagnostic process for spinal gout. Luckily, dual energy computed tomography (DECT) shows the crystals. However, healthcare providers must be aware of the possibility of gout to request the right test. (4) A narrative review of published studies on spinal gout that was done by two chiropractors concurred. To enhanced 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 be the key. (2) Dr. Paulette Hugulet, DC, LLC 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 limited his mobility and with no history of gout ended 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 confirmed spinal gout. 29% of patients with gout experience spinal gout, too, which did not help in this case of a patient without gout but is a noteworthy stat to consider in the next case. (5) A 41-year-old male who did have a 7-year history of gout came for help with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed invalidating an initial diagnosis of vertebral osteomyelitis. Primary treatment often includes symptom management with colchicine, steroids, urate lowering therapy, and NSAIDS. (6) If spinal gout is supposed, Dr. Paulette Hugulet, DC, LLC will get the right tests ordered.
CONTACT Dr. Paulette Hugulet, DC, LLC
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 La Grande chiropractic appointment soon. Your La Grande chiropractor will do a thorough examination to determine the best course to properly diagnose, treat, and attain the best relief of spinal gout.
