Affiliations 

  • 1 Rheumatology Unit, Sarawak General Hospital, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
  • 2 Radiology Department, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia. jatirmizi@unimas.my
  • 3 Orthopaedics Department, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
J Med Case Rep, 2019 Jan 08;13(1):8.
PMID: 30626451 DOI: 10.1186/s13256-018-1940-4

Abstract

BACKGROUND: Gout is a monosodium urate deposition disease which is prevalent worldwide. The usual manifestations are crystal arthropathy and tophi deposition in the soft tissues. Spinal tophi may also occur and are rarely reported, resulting in various clinical manifestations such as back pain, spinal cord compression, radiculopathy, and even mimicking epidural abscess and spondylodiscitis.

CASE PRESENTATION: We report a case of a 42-year-old Chinese man with underlying gout who presented with back pain and radiculopathy. The diagnosis of spinal tophi was unsuspected and he was initially treated for epidural abscess and spondylodiscitis. He underwent a laminectomy and posterolateral fusion during which tophus material was discovered. He recovered and medications for gout were started.

CONCLUSION: Spinal tophi are rare. The diagnosis is difficult and spinal tophi may be mistaken for epidural abscess, spondylodiscitis, or neoplasm.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.