Dos Santos Vitorino Modesto, Passini Soares Viviane Vieira, de Faria Priscilla Souza, Borges Viana Francisca Germanya Morais, Duarte Mayza Lemes
Department of Internal Medicine, Armed Forces Hospital, Cruzeiro Novo, Brasilia, Distrito Federal, Brazil;
Rom J Morphol Embryol. 2017;58(2):557-560.
The case study of peripheral and axial gouty arthritis is described in a 52-year-old man without concomitant clinical evidence of tophaceus gout on physical evaluation on admission. Gout is a metabolic disorder related to excess of uric acid in the extracellular compartment, and deposition of monosodium urate crystals in the joints and other sites. Arthritis and tophi are major manifestations, which more often involve the peripheral joints asymmetrically. Chronic tophaceous gout commonly develops after a decade of recurrent polyarticular gout. With lower frequency, the axial skeleton (spine and sacroiliac region) may be affected, condition sometimes associated with additional concerns, diagnostic challenges and pitfalls. Higher suspicion index and utilization of novel radiographic tools can settle these matters. Radiographic imaging exams include plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy to show bone erosion and joint lesions characterizing the spectrum of gouty osteoarthropathy.
一名52岁男性的外周和轴向痛风性关节炎病例研究如下，入院时体格检查未发现痛风石性痛风的相关临床证据。痛风是一种与细胞外液中尿酸过多以及关节和其他部位单钠尿酸盐晶体沉积相关的代谢紊乱疾病。关节炎和痛风石是主要表现，更常不对称地累及外周关节。慢性痛风石性痛风通常在反复多关节痛风发作十年后出现。轴向骨骼（脊柱和骶髂区域）受影响的频率较低，这种情况有时会带来更多问题、诊断挑战和陷阱。更高的怀疑指数和使用新型影像学工具可以解决这些问题。影像学检查包括X线平片、计算机断层扫描（CT）、磁共振成像（MRI）和骨闪烁显像，以显示痛风性骨关节炎谱系特征的骨质侵蚀和关节病变。
