Spinal gout diagnosis in chiropractic practice: narrative review.

Objective: To review and summarize the recent literature, increase awareness and provide guidance for chiropractic physicians regarding the diagnosis of spinal gout.

Methods: A search of PubMed was undertaken for recent case reports, reviews and trials relating to spinal gout.

Results: Our analysis of 38 cases of spinal gout revealed that 94% of spinal gout patients presented with back or neck pain, 86% displayed neurological symptoms, 72% had a history of gout, and 80% had raised serum uric acid levels. Seventy-six percent of cases proceeded to surgery. A combination of clinical findings, laboratory tests and appropriate utilization of Dual Energy Computed Tomography (DECT) has the potential to improve early diagnosis.

Conclusion: Gout is an uncommon cause of spine pain; however, it must be considered in the differential diagnosis as outlined in this paper. Increased awareness of the signs of spinal gout and earlier detection and treatment has the potential to improve the quality of life of patients and reduce the need for surgery.