Hasegawa Eduardo Massato, de Mello Filipe Martins, Goldenstein-Schainberg Cláudia, Fuller Ricardo
Rev Bras Reumatol. 2013 May-Jun;53(3):296-302.
Axial gout can affect all segments of the spine. It is manifested as back pain, as pain associated with neurological symptoms, and as neurological impairment without pain in 17.9%, 75.8% and 4.2% of cases, respectively. These manifestations were the first presentation of gout in many patients. Although x-rays as well as computed tomography and especially magnetic resonance scans can be very suggestive, histopathological, cytological and crystal analyses are the diagnostic gold standard. In most cases involving neurological manifestations, the patient underwent surgery, leading to satisfactory results. There are, however, some reports of full recovery following the usual clinical treatment for gout, suggesting that such treatment may be the initial option for those subjects with a history of gout and radiological findings of axial involvement.
轴性痛风可累及脊柱的所有节段。其表现为背痛，伴有神经症状的疼痛，以及分别在17.9%、75.8%和4.2%的病例中出现无疼痛的神经功能障碍。这些表现是许多患者痛风的首发症状。尽管X线以及计算机断层扫描，尤其是磁共振扫描可能具有很强的提示性，但组织病理学、细胞学和晶体分析是诊断的金标准。在大多数涉及神经表现的病例中，患者接受了手术，结果令人满意。然而，也有一些关于痛风常规临床治疗后完全康复的报道，这表明这种治疗可能是那些有痛风病史且有轴性受累影像学表现的患者的初始选择。
