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Tophaceous gout of the spine causing neural compression. 2013

Jong-Won Yoon, and Kyung-Bum Park, and Hyun Park, and Dong-Ho Kang, and Chul-Hee Lee, and Soo-Hyun Hwang, and Jin-Myung Jung, and Jong-Woo Han, and In Sung Park
Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Korea.

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.

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