Spinal Gout Diagnosed by Dual-Energy CT: A Case Report of Prior Misdiagnosis

It is commonly underestimated how widespread spinal gout can be; in the early phases, it might manifest without symptoms, or the pain it causes could be mistakenly assigned to other conditions that are more commonly seen. The case study outlined in this article revolves around a 35-year-old woman who endured persistent lower back pain over a two-year period, through which she pursued care from multiple medical facilities and specialists, yet saw little to no relief. Lately, her health has worsened, leading to the emergence of widespread pain in both of her legs. A diagnosis of spinal gout was established through dual-energy CT, and the patient was subsequently treated with Febuxostat to reduce uric acid levels, leading to a resolution of her pain. After monitoring for 15 months, symptoms did not reappear. The utility of dual-energy CT in diagnosing and managing spinal gout is highlighted in this paper, as evidenced by the case presented. Furthermore, it is crucial to recognize that the clinical manifestations of spinal gout are often atypical, warranting heightened awareness and consideration in clinical practice.