Case reportWhen gout involves the spine: Five patients including two inaugural cases
Introduction
Gout remains a topical issue. This multifaceted disease [1], [2] continues to raise diagnostic problems [3]. Although involvement of the spine is considered rare, lesions of the disks and vertebral bodies or facet joints have been reported, as well as neurological complications related to tophi [4], [5], [6]. Here, we describe findings in five patients with spinal gout seen at a single center. In two of these patients, the spinal lesions were inaugural.
Section snippets
Methods
All five cases of spinal gout were diagnosed at a single center over a 3-year period. The diagnostic relied on EULAR criteria [3] in three patients and on converging evidence including at least a history of acute gout attacks that responded well to colchicine in the two remaining patients. We collected the following data for each patient: age, gender, medical history, co-morbidities, presenting symptoms, imaging study findings, laboratory test results, treatment, and outcome. For the three
Results
Table 1 reports the main data for the five patients. There were four men and one woman aged 51 to 87 years. Three patients had a previous history of acute gout attacks. Co-morbidities were present in all five patients and consisted of hypertension (n = 3), heart failure (n = 2), chronic kidney failure (n = 1), hypercholesterolemia (n = 1), and polychondritis (n = 1). The patients presented with inflammatory pain in the cervical (n = 2) or lumbar (n = 3) spine, with an acute onset in four of five cases. One
Discussion
Spinal involvement with gout has chiefly been described as anecdotal case reports. Our case-series of five patients illustrates various types of spinal lesions due to gout: discitis, discovertebral tophus, and facet joint deposits.
Disclosure of interest
The authors declare that they have no conflicts of interest concerning this article.
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