Diagnosis is key to Relief of Montreal Spinal Gout
Gout. If you’ve experienced gout, you know how unpleasant it is. You may also know how tough it was to diagnose, especially if it was in the spine. Back pain or leg pain might have been your first symptom. Your Montreal chiropractor at Dr. Hoang's Chiropractic Clinic understands spinal gout, its similarities with other conditions’ symptoms, and the latest advised tests to diagnose it early to help you get the (appropriate!) care you need.
PREVALENCE OF SPINAL GOUT
Arthritis is an inflammatory condition impacting people around the world - 47.8 million US sufferers, 8 million UK sufferers, 108 million European sufferers - with osteoarthritis being the most common affecting joints in the knee, hands, etc. Gout is just such an inflammatory cause of pain in similar areas, making it challenging to diagnose and differentiate from other inflammatory issues. (1) A recent narrative review reported that 94% of spinal gout patients experienced back or neck pain, 86% showed neurological symptoms, 72% had a history of gout, 80% had elevated levels of serum uric acid, and 76% went through a surgery. Though an infrequent cause of spine pain, gout’s inflammatory arthritis stems from monosodium urate crystals in synovial fluid and other joint tissues (ankle, foot, hands, wrists, elbows, knees, hips, and spine). (2) An early, appropriate diagnosis of spinal gout can better guide treatment and enhance clinical outcomes.
DIAGNOSIS OF SPINAL GOUT
Researchers have investigated various ways to safely and accurately diagnose gout in people who have never experienced gout. They have analyzed studies going back as far as 1945! They found that synovial fluid monosodium urate crystal analysis and imaging were superior to a clinical algorithm of signs and symptoms only for diagnosis and treatment planning. (3) Facet joint disorders, osteoarthritis, synovial cysts, etc., can complicate the diagnostic process for spinal gout. Luckily, dual energy computed tomography (DECT) illustrates the crystals. However, healthcare providers must be aware of the possibility of gout to request the proper test. (4) A narrative review of published studies on spinal gout that was undertaken by two chiropractors concurred. To improve the quality of life of spinal gout sufferers as well as the diagnosis, treatment planning and prevention of surgery, a combination of clinical symptoms, lab tests, and DECT may hold the key. (2) Dr. Hoang's Chiropractic Clinic notes that cases of spinal gout are emerging in the medical literature.
CASES OF SPINAL GOUT and TREATMENT
One case of a 48-year-old man with sudden, severe, sharp low back pain that limited his mobility and with no history of gout wound up with a diagnosis of spinal gout after an MRI revealed a mass in his right erector spinae muscles which lead to a pathological exam showed spinal gout. 29% of patients with gout are affected by spinal gout, too, which didn’t help in this case of a patient without gout but is an interesting stat to consider in the next case. (5) A 41-year-old male who did have a 7-year history of gout came for help with severe back pain, fevers, and radiculopathy. After a biopsy, spinal gout was diagnosed invalidating an initial diagnosis of vertebral osteomyelitis. Primary treatment often includes symptom management with colchicine, steroids, urate decreasing therapy, and NSAIDS. (6) If spinal gout is supposed, Dr. Hoang's Chiropractic Clinic will get the right tests ordered.
CONTACT Dr. Hoang's Chiropractic Clinic
Listen to this PODCAST with Dr. Joseph Beissel on The Back Doctors Podcast with Dr. Michael Johnson as he describes the relief with The Cox® Technic System of Spinal Pain Management for chronic back pain.
Make your Montreal chiropractic appointment soon. Your Montreal chiropractor will do a complete examination to figure out the best course to appropriately diagnose, treat, and attain the best relief of spinal gout.
