technetium-tc-99m-medronate and Gout

Single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging of the gouty spine is rare. We describe a 66-year-old man who presented with pain and numbness in the right lower leg; he reported a 2-month history of intermittent low back pain. Imaging revealed neoplastic lesions of the spine, which were initially regarded as tumors. Thus, the patient underwent surgical removal of the lumbar lesion. However, the postoperative pathological diagnosis was gout spondylitis. In this report, we show multimodal images of advanced gout spondylitis. The metabolic information provided by SPECT/CT, combined with the microscopic changes in bone structure revealed by dual-source thin-layer CT and the anatomical localization information provided by magnetic resonance imaging, can help clinicians to more fully understand the pathophysiological mechanisms and imaging manifestations of gout from multiple perspectives, thereby reducing the rate of misdiagnosis.

Topics: Aged; Gout; Humans; Male; Spondylarthritis; Spondylitis; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Aged; Arthritis, Infectious; Gout; Hallux; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Staphylococcal Infections; Staphylococcus aureus; Technetium Tc 99m Medronate

Topics: Aged; Bone and Bones; Gout; Humans; Male; Osteitis Deformans; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate

In a study designed to evaluate the radionuclide images in patients with gout, six (23%) of the 26 patients had clear evidence of Paget's disease of bone by technetium Tc 99m medronate imaging. A reference population consisting of 333 technetium Tc 99m medronate bone scans ordered for other reasons was reviewed, and only seven scans (2.1%) were found to have evidence of Paget's disease. This difference was found to be highly significant. All cases of Paget's disease were confirmed by independent radiologic evaluation. We conclude that there is a significant association between Paget's disease and gout, the basis for which is not yet known.

Topics: Aged; Aged, 80 and over; Gout; Humans; Male; Middle Aged; Osteitis Deformans; Radionuclide Imaging; Technetium Tc 99m Medronate; Uric Acid