Hip pain as the presenting manifestation of acute gouty sacroiliitis

Gout can present in a variety of less typical forms. We describe a case of an elderly woman presenting with hip and lower extremity pain. It remained undiagnosed for several days but proved to be secondary to gouty involvemen t of the right sacroiliac (SI) joint. Monosodium urate crystals were identi fied in computed tomographic guided aspiration of the SI joint. The importa nce of obtaining a good history and performing a complete physical examinat ion if the diagnosis of sacroiliitis (or any other musculoskeletal disorder ) is to be made, its cause defined, and proper treatment instituted is emph asized.