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Tophaceous Gout of the Spine Causing Neural Compression
Jong-Won Yoon (Gyeongsang National University, Gyeongsang National University Hospital), Kyung-Bum Park (Gyeongsang National University, Gyeongsang National University Hospital), Hyun Chul Park (Gyeongsang National University, Gyeongsang National University Hospital), Dong-Ho Kang (Gyeongsang National University, Gyeongsang National University Hospital), Chul-Hee Lee (Gyeongsang National University, Gyeongsang National University Hospital), Soo-Hyun Hwang (Gyeongsang National University, Gyeongsang National University Hospital), Jin‐Myung Jung (Gyeongsang National University, Gyeongsang National University Hospital), Jong-Woo Han (Gyeongsang National University, Gyeongsang National University Hospital), In Sung Park (Gyeongsang National University, Gyeongsang National University Hospital)
Abstract: Gout is a common metabolic disease in which monosodium urate crystals called tophi develop. Spinal involvement in gout resulting in neural compression is unusual. We describe a case of a 64-year-old man with a history of gouty arthritis of the knee. The patient presented with thoracic myelopathy and radiculopathy. Imaging of the spine revealed an extradural mass lesion with bony erosion of the thoracic spine. A decompressive operation was performed, and a chalky white material was found. Histopathological examination confirmed a gouty tophus. The symptoms of spinal gout vary and its radiological features are not sufficiently specific to provide a definite diagnosis. Therefore, in patients with a history of gouty arthritis who present with neural compressive symptoms of the spine, spinal gout should be strongly suspected.