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脊柱也会得痛风?有这些症状的时候要注意了!

时间:2017-07-11 作者: 痛风防治只能

● 研究目的
总结2000年至2014年期间发表的文献中关于“脊柱痛风”的临床表现和治疗方案,探讨“脊柱痛风”形成的发病机制。

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● 研究方法我们查阅了68个病例,分析了“脊柱痛风”的临床特征、好发部位、实验室检查、影像学检查、治疗方案。 ● 研究结果68名患者中,最常见的临床表现是背痛、脖子痛,最常见的实验室检查结果是血尿酸升高,最常见的影像学检查结果是磁共振(MRI)T1加权相出现“痛风石”的低密度影。最常用的外科治疗方案是“椎板切除术”,而有29.4%的患者选择了内科治疗。 ● 研究结论“脊柱痛风”的患者常出现背痛或脖子痛,常伴有尿酸升高。“脊柱痛风”的诊断,主要根据组织中出现负性双折光的单钠尿酸盐晶体。其治疗包括内科治疗和外科治疗,内科治疗即服用降尿酸药物,当内科治疗效果欠佳时,患者就要准备接受外科手术治疗。


专家解释

“脊柱痛风”在我国比较少见,假如朋友们(特别是尿酸高的)长期都有背痛、脖子痛的情况,最好去正规医院做个检查,查一查磁共振(MRI)、尿酸,明确是否得了“脊柱痛风”。

“脊柱痛风”的治疗方法也很简单,先吃药,把尿酸降下来,效果不行的,再去做手术。

背痛、脖子痛,是生活中很常见的现象,很容易被忽视,大家都以为只是工作疲劳、休息一下就好了。实际上这是不对的,长期都痛的,最好去检查一下,早发现、早治疗。

对于尿酸高的朋友们,更加要留意自己是不是得了“脊柱痛风”,千万不能马虎。


· 原文 ·

Spinal gout: A review with case illustration.

World J Orthop. 2016 Nov 18;7(11):766-775.eCollection 2016 Nov 18.

 

Author


ElgafyH1, Liu X1, Herron J1.

 

Author information


1.Hossein Elgafy, Xiaochen Liu, JosephHerron, Department of Orthopedics, University of Toledo Medical Center, Toledo,OH 43614-5807, United States.


Abstract

● AIM

To summarize clinical presentations and treatment options of spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation.

● METHODS

The authors reviewed 68 published cases of spinal gout, which were collected by searching "spinal gout" on PubMed from 2000 to 2014. The data were analyzed for clinical features,anatomical location of spinal gout, laboratory studies, imaging studies, and treatment choices.

● RESULTS

Of the 68 patients reviewed, the most common clinical presentation was back or neck pain in 69.1% of patients. The most common laboratory study was elevated uric acid levels in 66.2% of patients. The most common diagnostic image finding was hypointense lesion of the gout tophi on the T1-weighted magnetic resonance imaging scan. The most common surgical treatment performed was a laminectomy in 51.5% and non-surgicaltreatment was performed in 29.4% of patients.

● CONCLUSION

Spinal gout most commonly present as backor neck pain with majority of reported patients with elevated uric acid. The diagnosis of spinal gout is confirmed with the presence of negatively birefringent monosodium urate crystals in tissue. Treatment for spinal gout involves medication for the reduction of uric acid level and surgery if patient symptoms failed to respond to medical treatment.

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