A rare case of gouty arthropathy in the spine complicated with acute cord compression

Gout is one of the most common inflammatory arthropathies in the developed world. However, involvement of the spine is relatively rare, and other sinister differential diagnoses will need to be considered. We describe an unusual case of gouty tophi deposition within the spine in an elderly patient presenting with signs and symptoms of acute cord compression. Important differential diagnoses that need to be excluded include bony metastases from underlying malignancy and other infective/inflammatory causes. Early recognition of imaging findings can avoid delayed or inappropriate medical treatment.