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Related Experiment Videos

Cervical myelopathy caused by pseudogout

J S Norris1, D T Hope

  • 1Department of Neurosurgery, University Hospital, Queens' Medical Centre, Nottingham, UK.

British Journal of Neurosurgery
|January 1, 1995
PubMed
Summary

Pseudogout can cause cervical myelopathy, a spinal cord condition, in elderly individuals. Surgical removal of the crystal deposits offers definitive treatment for this rare presentation.

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Area of Science:

  • Neurology
  • Rheumatology
  • Spinal Surgery

Background:

  • Pseudogout (calcium pyrophosphate dihydrate crystal deposition disease) typically affects joints like the knee or wrist.
  • Cervical myelopathy presents with progressive neurological deficits due to spinal cord compression in the neck.
  • Extradural compression in the cervical spine is often caused by disc herniation, tumors, or ossification of the posterior longitudinal ligament.

Observation:

  • A rare case of pseudogout presenting as cervical myelopathy is described.
  • The patient exhibited symptoms of progressive myelopathy with evidence of extradural compression on imaging.
  • The characteristic stigmata of gout were absent in this case.

Findings:

  • Surgical exploration revealed a crystalline mass compressing the cervical spinal cord.
  • Histopathological analysis confirmed the presence of calcium pyrophosphate dihydrate crystals.
  • The crystalline mass was successfully removed surgically.

Implications:

  • This case highlights pseudogout as a potential, albeit uncommon, cause of cervical myelopathy.
  • Early consideration of pseudogout is crucial in elderly patients with progressive myelopathy and extradural compression, even without typical gout symptoms.
  • Surgical intervention provides a definitive treatment option by relieving spinal cord compression.

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