Acute gouty sacroiliitis: a case report and review of the literature.

A 45-year-old black woman with an acute attack of severe unilateral sacroiliitis, negative microbiologic studies, is presented. An open biopsy specimen of the sacroiliac joint revealed evidence of tophaceous gout. The unique features of the case, differential diagnosis, and pertinent literature on gouty sacroiliitis are reviewed. Acute gouty sacroiliitis, although it is rare, does occur and should be included in the differential diagnosis of unilateral sacroiliitis in patients with a long-standing history of gout.