Xian ETW, Xian SKS, Ming YP. A unique presentation of acute tophaceous gout in the lumbar spine causing cauda equina syndrome.
Radiol Case Rep 2023;
18:3341-3345. [PMID:
37520396 PMCID:
PMC10371789 DOI:
10.1016/j.radcr.2023.06.070]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Gout is a common metabolic disease characterized by the deposition of monosodium urate (MSU) crystals and typically affects the peripheral joint, rarely involving the axial skeleton. We present a rare case of acute tophaceous gout in the lumbar spine causing cauda equina syndrome. A 60-year-old man with a history of gout and prior admissions for polyarticular gout flare presented with acute onset of bilateral lower limb numbness and weakness. He underwent surgical decompression with drainage of the epidural collection, with histology consistent with tophaceous gout. The patient made a full recovery postoperatively and was discharged uneventfully. Due to the high initial suspicion for gout, early spinal decompression surgery was performed, and the patient was started on medical therapy. Spinal tophaceous should be considered in the list of different diagnoses of spinal epidural masses especially in the context of a history of gouty arthritis.
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