Chen Wenji, Wang Yanyan, Li Yan, Zhao Zheng, Feng Lixia, Zhu Jian, Zhang Jianglin, Huang Feng
Department of Rheumatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya.
Department of Rheumatology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
J Pain Res. 2017 Jun 29;10:1511-1514. doi: 10.2147/JPR.S133572. eCollection 2017.
Gout is clinically characterized by episodes of monoarthritis, which not only typically affects the peripheral joints but also occasionally affect the axial joint, such as the sacroiliac joint (SIJ), and often mimics spondyloarthritis (SpA). Two cases of gout mimicking SpA are presented in the current paper. One patient was a 32-year-old man with a history of asymmetrical oligoarthritis of ankle and metatarsophalangeal joints (MTPJ). He had left gluteal pain for 2 weeks. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the bone erosion of the left SIJ. T1-weighted MRI showed hypointense T1 and hyperintense T2 signals of the left SIJ. The other patient was a 24-year-old man with left back pain and hip pain for 4 months and intermittent fever for 3 months. He had a history of gout for 3 years. Both patients underwent CT-guided sacroiliac biopsy, and monosodium urate (MSU) crystals were shown by polarized microscopy. Gout can often mimic SpA and seldomly affects the SIJ. Thus, its correct diagnosis and adequate therapy can halt the development of such damaging complications.
痛风的临床特征为单关节炎发作，不仅通常累及外周关节，偶尔也会累及轴性关节，如骶髂关节（SIJ），且常酷似脊柱关节炎（SpA）。本文介绍了两例酷似SpA的痛风病例。一名患者为32岁男性，有踝关节和跖趾关节（MTPJ）不对称性少关节炎病史。他左侧臀部疼痛2周。计算机断层扫描（CT）和磁共振成像（MRI）显示左侧骶髂关节骨质侵蚀。T1加权MRI显示左侧骶髂关节T1低信号和T2高信号。另一名患者为24岁男性，左侧背痛和髋部疼痛4个月，间歇性发热3个月。他有3年痛风病史。两名患者均接受了CT引导下的骶髂关节活检，偏振显微镜检查显示有尿酸钠（MSU）结晶。痛风常可酷似SpA，很少累及骶髂关节。因此，其正确诊断和充分治疗可阻止此类破坏性并发症的发展。
