Jin Hyo-Joon, Son Eun-Seok, Kim Du Hwan
Department of Rehabilitation Medicine, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
Front Med (Lausanne). 2020 Aug 5;7:339. doi: 10.3389/fmed.2020.00339. eCollection 2020.
This study aimed to describe the frequency of axial deposition (axial gout) and determine the associated factors in patients with gout who presented to a spine clinic in Korea. We enrolled 95 Korean patients who visited our spine center from March 2012 to February 2016 and who had been previously diagnosed with gout and had available computed tomography (CT) images of the vertebral columns. Axial gout was defined as the presence of erosions or tophi in the vertebral endplate or facet joint. The clinical and laboratory data of these patients were retrieved from medical records. Out of 95 patients, 15 [15.8%; 95% confidence interval (CI), 9.4-25.0%] had a conventional CT evidence suggestive of axial gout. In these 15 patients, 12 (80%) had lumbar spine involvement (95% CI, 51.4-94.7%). Fifteen patients had erosions of the vertebral column, and two presented with tophi that exhibited erosive changes of the facet joints. The presence of axial gout was not associated with the patients' age, duration of gout, laboratory findings, inflammatory back pain symptoms, identification of monosodium urate crystals in the peripheral joints, current use of urate-lowering drugs, hypertension, and end-stage renal disease; however, there was a significant association with the presence of diabetes ( = 0.008). The frequency of axial deposition in Korean patients with gout and spinal symptoms was 15.8%, with the lumbar region being the most commonly involved section of the spine. In addition, diabetes was associated with evidence of axial gout on imaging.
本研究旨在描述轴向沉积(轴向痛风)的发生率,并确定韩国一家脊柱诊所中痛风患者的相关因素。我们纳入了95例2012年3月至2016年2月期间就诊于我们脊柱中心、先前已被诊断为痛风且有可用的脊柱计算机断层扫描(CT)图像的韩国患者。轴向痛风定义为椎体终板或小关节存在侵蚀或痛风石。这些患者的临床和实验室数据从病历中获取。在95例患者中,15例[15.8%;95%置信区间(CI),9.4 - 25.0%]有传统CT证据提示轴向痛风。在这15例患者中,12例(80%)有腰椎受累(95% CI,51.4 - 94.7%)。15例患者有脊柱侵蚀,2例出现痛风石,其小关节表现出侵蚀性改变。轴向痛风的存在与患者年龄、痛风病程、实验室检查结果、炎性背痛症状、外周关节中尿酸钠晶体的鉴定、当前使用降尿酸药物、高血压和终末期肾病无关;然而,与糖尿病的存在有显著相关性( = 0.008)。有脊柱症状的韩国痛风患者中轴向沉积的发生率为15.8%,腰椎是脊柱最常受累的部位。此外,糖尿病与影像学上轴向痛风的证据相关。