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Spinal tophaceous gout encasing the thoracic spinal cord
Nagina Subrati1, Melissa C Werndle1, Christos M Tolias1
1Department of Neurosurgery, Kings College London, London, UK.
BMJ Case Reports
|October 6, 2016
Summary
Gout rarely affects the thoracic spinal cord. This case highlights tophaceous gout mimicking a spinal abscess in a patient with paraparesis.
Area of Science:
- Neurology
- Rheumatology
- Spinal Surgery
Background:
- Thoracic spinal cord compression is uncommon in gout.
- Gout typically affects peripheral joints, rarely presenting as a spinal epidural mass.
Observation:
- A 43-year-old male presented with progressive lower limb paraparesis.
- Magnetic Resonance Imaging (MRI) revealed a T10/T11 soft tissue swelling, initially presumed to be an abscess.
Findings:
- Surgical decompression and biopsy were performed.
- Histopathology definitively diagnosed tophaceous gout, not an abscess.
Implications:
- This case underscores the importance of considering unusual presentations of gout.
- Tophaceous gout can mimic spinal infections, necessitating accurate histopathological diagnosis for appropriate management.
- Early recognition and treatment are crucial to prevent irreversible neurological damage.
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