Tophaceous gout in the cervical spine

Cabot, J R; Mosel, Leigh; Kong, Andrew; Hayward, Mike

doi:10.1007/s00256-005-0920-0

Cited by 23 publications

(10 citation statements)

References 10 publications

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“…4,5 An analysis of the literature indicated that all segments of the spine could be involved with gout. [6][7][8][9] The lower lumbar spine is the most common region involved, particularly the L4-5 level. [10][11][12][13] Only 20 cases of tophus in the dorsal vertebrae have been described in the literature (see Table 1 6-20 ).…”

Section: Discussionmentioning

confidence: 99%

Thoracic spinal cord compression by extradural tophus: a case report and review of the literature

Liu

Zhu

2015

Spinal Cord Ser Cases

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STUDY DESIGN: Case report and literature review. OBJECTIVES: Gouty arthritis of the spine is rare. Gout presenting as back pain and quadriplegia may be difficult to distinguish from a spinal tumor. Symptoms vary, and the diagnosis is often delayed. We report an unusual case of thoracic spinal cord compression caused by extradural tophaceous deposits whose initial diagnosis had been lymphoid malignancy. To the best of our knowledge, this is only the second report of using single-photon emission computed tomography (SPECT) to diagnose spinal tophus. METHODS: We retrospectively reviewed the medical records, operative reports and radiographic imaging studies of a single patient. RESULTS: A 26-year-old man with severe tophaceous gout presented with a 4-month history of progressive weakness and dyschesia of both lower extremities. Coronal bone slices evaluated by SPECT indicated increased methylene diphosphonate uptake in the T9 and T10 pedicles. Pathology assessment revealed areas of amorphous substance containing urate crystals surrounded by inflammatory cells. The diagnosis was gouty tophus. CONCLUSION: The position of the spinal tophus may be related to the 'S' type of spinal anatomical structure. Obesity and inactivity may be the two risk factors for spinal tophus. Every effort should be made to lower the serum uric acid level by maximizing the pharmacological regimen. We believe that laminectomy can effectively relieve spinal cord compression. It also improves the longterm prognosis for spinal gouty tophus. SPECT may be a viable method for differentiating spinal gout and a malignant tumor. Spinal Cord Series and Cases INTRODUCTIONWe report a case of gouty arthritis affecting the thoracic spine in a 26-year-old man with thoracic spinal cord compression caused by extradural tophaceous deposits that had initially been diagnosed as lymphoid malignancy.

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Section: Discussionmentioning

confidence: 99%

Thoracic spinal cord compression by extradural tophus: a case report and review of the literature

Liu

Zhu

2015

Spinal Cord Ser Cases

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“…Hyperuricemia often goes untreated for a long time, as in the case of our patient. The lesions can occur in any area of the cervical spine, but are most frequently seen in C4-7 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). If severe neurological symptoms are present, orthopedic surgery is usually performed; otherwise a course of drug treatment is prescribed.…”

Section: Discussionmentioning

confidence: 99%

Tophaceous Gout in the Cervical Spine

et al. 2012

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A 58-year-old woman with a three-year progressive history of chronic arthritis, had become disabled due to general malaise and fever. Her laboratory data revealed hyperuricemia and elevated levels of C-reactive protein. Neither rheumatoid factor nor anti-citrullinated peptide antibodies were present. We diagnosed her with tophaceous gout with uric crystalline revealed by the arthrocentesis of the elbow. 99m Tc scintigraphy also disclosed a significant uptake in the cervical spine. The CT of the patient's cervical spine revealed significant bone erosion and destruction. We diagnosed the cervical involvement of gout based on the exclusion of infections and sarcoidosis. Rheumatologists should be aware of this rare association.

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“…Photomicrograph of another section had been stained by de Galantha's method for demonstration of monosodium urate crystals ( Figure 2). subcutaneous nodules, knee, acromioclavicular joint and axial skeleton [3][4][5][6][7][8][9][10][11][12][13][14]. A recent study suggested that the frequency of axial involvement may be as high as 14% in patients with clinical or crystal-proven gout [15].…”

Section: Case Reportmentioning

confidence: 99%

Tophi gout around the knee joint: An unusual presentation with a soft tissue mass

Özkan¹,

Bilsel²,

Türkmen³

et al. 2013

IJCRI

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Introduction: Gout is the most common inflammatory arthropathy. It has been reported to affect 2.13% of population in the United states. In this report, we presented an uncommon case of tophaceous gout of the knee presenting as a soft tissue mass. case report: A 57-year-old male patient with knee pain and localized progressive swelling increasing in time on the medial side of the proximal tibia was seen in our clinic. He did not have any rheumatologic disease known previously except gout arthritis. Excisional biopsy was performed by preserving medial collateral ligament and histopathologic investigations were done next. A tophaceous gouty deposit was identified by low-power photomicrograph. A bluish amorphous material was seen surrounded by bundles of dense collagenized tissue and chronic inflammatory cells. surrounding the amorphous crystalline deposit is a thin layer of mononuclear and giant cells. Photomicrograph of another section has been stained by de Galantha's method for demonstration of monosodium urate crystals. conclusion: Especially in patients with extra-articular or subcutaneus mass, tophaceous gout must be considered as differential diagnosis.

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Tophaceous gout in the cervical spine

Cited by 23 publications

References 10 publications

Thoracic spinal cord compression by extradural tophus: a case report and review of the literature

Thoracic spinal cord compression by extradural tophus: a case report and review of the literature

Tophaceous Gout in the Cervical Spine

Tophi gout around the knee joint: An unusual presentation with a soft tissue mass

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