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A unique presentation of acute tophaceous gout in the lumbar spine causing cauda equina syndrome – Lumbar Spinal Stenosis

This article discusses a rare case of acute tophaceous gout in the lumbar spine, which caused cauda equina syndrome in a 60-year-old man with a history of gout. Tophaceous gout is a condition characterized by the deposition of monosodium urate (MSU) crystals, typically affecting the peripheral joints. However, in this case, the condition affected the axial skeleton. The patient underwent surgical decompression and drainage of the epidural collection, with histology confirming the presence of tophaceous gout. The patient had a full recovery after the surgery and was discharged without any complications. The article emphasizes the importance of considering spinal tophaceous gout as a possible diagnosis in patients with spinal epidural masses, particularly in those with a history of gouty arthritis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Gout is a common metabolic disease characterized by the deposition of monosodium urate (MSU) crystals and typically affects the peripheral joint, rarely involving the axial skeleton. We present a rare case of acute tophaceous gout in the lumbar spine causing cauda equina syndrome. A 60-year-old man with a history of gout and prior admissions for polyarticular gout flare presented with acute onset of bilateral lower limb numbness and weakness. He underwent surgical decompression with drainage of…

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Radiol Case Rep. 2023 Jul 14;18(9):3341-3345. doi: 10.1016/j.radcr.2023.06.070. eCollection 2023 Sep.ABSTRACTGout is a common metabolic disease characterized by the deposition of monosodium urate (MSU) crystals and typically affects the peripheral joint, rarely involving the axial skeleton. We present a rare case of acute tophaceous gout in the lumbar spine causing cauda equina syndrome. A 60-year-old,

Radiol Case Rep. 2023 Jul 14;18(9):3341-3345. doi: 10.1016/j.radcr.2023.06.070. eCollection 2023 Sep.

ABSTRACT

Gout is a common metabolic disease characterized by the deposition of monosodium urate (MSU) crystals and typically affects the peripheral joint, rarely involving the axial skeleton. We present a rare case of acute tophaceous gout in the lumbar spine causing cauda equina syndrome. A 60-year-old man with a history of gout and prior admissions for polyarticular gout flare presented with acute onset of bilateral lower limb numbness and weakness. He underwent surgical decompression with drainage of the epidural collection, with histology consistent with tophaceous gout. The patient made a full recovery postoperatively and was discharged uneventfully. Due to the high initial suspicion for gout, early spinal decompression surgery was performed, and the patient was started on medical therapy. Spinal tophaceous should be considered in the list of different diagnoses of spinal epidural masses especially in the context of a history of gouty arthritis.

PMID:37520396 | PMC:PMC10371789 | DOI:10.1016/j.radcr.2023.06.070

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A unique presentation of acute tophaceous gout in the lumbar spine causing cauda equina syndrome

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Radiol Case Rep. 2023 Jul 14;18(9):3341-3345. doi: 10.1016/j.radcr.2023.06.070. eCollection 2023 Sep.ABSTRACTGout is a common metabolic disease characterized by the deposition of monosodium urate (MSU) crystals and typically affects the peripheral joint, rarely involving the axial skeleton. We present a rare case of acute tophaceous gout in the lumbar spine causing cauda equina syndrome. A 60-year-old

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