Tophaceous Gout of the Spine: MR Imaging Features (original) (raw)
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Tophaceous gout of the spine: A case report and review of the literature
Tophaceous gout is the final phase in the development of gout. Tophi form from the deposition of monosodium urate crystals can be found in the surrounding joints and periarticular tissues. Accumulation of tophi in the spine is rare. We report a case of spinal gout involving the thoracic spine resulted in spinal cord compression and incomplete paraplegia. Surgery was performed for decompressing the spinal canal, and tophaceous gout is certified from intraoperative and histological examination. KeyWords: images study, spinal cord compression, tophaceous gout
Gout in the cervical spine: MR pattern mimicking diskovertebral infection
AJNR. American journal of neuroradiology, 1996
We report the MR features of a surgically proved cervical spine involved with gouty tophi in a patient with a long history of hyperuricemia. Tophi appeared as sharply delineated areas of low signal intensity on T1 and T2 MR images and showed intense and homogeneous signal enhancement on post-contrast images.
Arthritis and Rheumatism, 1985
Monosodium urate crystal deposition in joints and periarticular connective tissue is a characteristic feature of chronic gout. Tophi are typically found in the joints of the appendicular skeleton; extraskeletal tophi are less commonly seen. Reports of tophi in the axial skeleton are rare, and there are only 6 reports of tophaceous deposits causing neurologic symptoms secondary to spinal cord or nerve root compression. We report the first case of radiculopathy caused by a tophus in a patient who did not have a history of polyarticular, tophaceous gout.
Tophaceous Gout in the Cervical Spine
Internal Medicine, 2012
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.
Evidence-based spine-care journal, 2014
Study Design Case report. Objective The objective of this study is to report the occurrence of tophaceous gout in the lumbar spine. Methods Using a case report to illustrate the key points of gout in the spine, we provide a brief review of gout in the literature as it relates to its orthopedic and spinal manifestations as well as guidelines for management. Results This case report details the occurrence of a large and clinically significant finding of tophaceous gout in the lumbar spine in a 24-year-old man with a known history of gout and a 3-year history of progressive back pain. Conclusion A high index of suspicion can assist in diagnosis of patients presenting with back pain or neurologic findings with a history of gout. A previous history of gout (especially the presence of tophi), hyperuricemia, and the radiological characteristics presented here should aid the clinician in making the diagnosis of spinal gout. Early diagnosis has the potential to prevent the need for surgical ...
Spinal gout tophus: a very rare cause of radiculopathy
European Spine Journal, 2011
Gout is a common metabolic disease characterized by the development of arthritis and nephropathy related to the deposition of monosodium urate crystals within the joints, periarticular tissues, skin and kidneys. Tophus formation seen around the spinal column is very rare, while occurrences of spinal gout tophus without systemic gout disease are much more unique. In our study, we report a spinal gout case that presented with right sciatica without previous history of systemic gout disease.
Tophaceous gout in the lumbar spine causing radiculopathy
Reumatología Clínica (English Edition), 2019
Tophaceous deposits in lumbar spine are considered a rare condition. We report the case of a 44-year-old patient with low back pain and radiculopathy. Radiographs revealed lytic spondylolisthesis in L5. Magnetic resonance imaging showed hypointense signal on T1 and a heterogeneous signal on T2 located in the L4-L5 interspinous space and in the left facet joint that invades left neuroforamen. The left knee ultrasound showed "double contour" of the medial femoral condyle. Decompressive laminectomy with arthrodesis at the level of L5-S1 was performed. The histological examination revealed amorphous material with a foreign body giant cell reaction.
Tophaceous gout of the lumbar spine mimicking an epidural abscess: MR featurew
American journal of …, 1996
We present the MR findings in a case of tophaceous gout of the lumbar spine with cauda equina compression, mimicking an epidural abscess. The diagnosis was clinically unsuspected and confirmed at laminectomy. Tophus material in the paraspinal soft tissues appeared intermediate in signal intensity and showed heterogeneous contrast enhancement.
Tophaceous gout of the cervical and thoracic spine with concomitant epidural infection
AME case reports, 2018
Tophaceous gout of the spine is an underappreciated source of back pain in patients with or without neurological decline. It has been reported to occur in the cervical, thoracic and lumbar spine. Rarely, does it occur at more than one region of the spine. Advanced imaging with magnetic resonance imaging and computed tomography are usually not helpful in differentiating between infection, malignancy and gout. Clinician should have a high suspicion of spinal gout in patients with history of gout who presents with renal insufficiency, presence of peripheral tophi on exam, with elevated serum uric acid and creatinine levels, erythrocyte sedimentation rate and C-reactive protein. Here we present a case of a 23-year-old male with history of gout and chronic renal disease with progressive weakness in his lower extremities with new urinary incontinence who was found to have spinal gout with epidural infection of both the cervical and thoracic spine. Our patient was successfully managed with...