Affiliation:
1. Department of Nuclear Medicine and PET, Nepean Hospital, Kingswood
Abstract
Abstract
A 74-year-old woman was referred for 18F-FDG PET/CT for the evaluation of incidental CT finding of expansile destruction of left L4/5 facet joint with associated soft tissue mass concerning for a metastatic deposit. The FDG PET/CT revealed variable abnormally increased FDG activity involving multiple facet joints in all regions of the spine with corresponding expansile “punched-out” lytic lesions with sclerotic rims and overhanging margins on CT, raising the possibility of inflammatory polyarthropathy, including gout, as a differential diagnosis. Dual-energy CT of lumbar spine and CT-guided biopsy and culture of the left L4/5 facet joint demonstrated the presence of urate crystal deposition with no evidence of malignancy or infection, confirming the diagnosis of multilevel tophaceous gout of the spine.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference9 articles.
1. Spinal gout: a review with case illustration;World J Orthop,2016
2. Spinal and sacroiliac gouty arthritis: report of a case and review of the literature;Acta Radiol Short Rep,2014
3. A case of gouty arthritis to tophi on 18F-FDG PET/CT imaging;Clin Nucl Med,2012
4. Widespread gouty tophi on 18F-FDG PET/CT imaging;Clin Nucl Med,2014
5. Spinal cord compression by tophaceous gout with fluorodeoxyglucose-positron-emission tomographic/MR fusion imaging;AJNR Am J Neuroradiol,2006