Tophaceous gout of the lumbar spine mimicking pyogenic discitis

Spine J. 2007 Jan-Feb;7(1):94-9. doi: 10.1016/j.spinee.2006.01.009. Epub 2006 Nov 28.

Abstract

Background context: Gout of the spine is very rare. Forty-one cases of gout affecting the spine have been reported.

Purpose: To present a patient with tophaceous gout of the lumbar spine mimicking pyogenic discitis.

Study design: Case report.

Methods: The medical record, including operative notes, progress notes, discharge summary, clinical notes, radiological study, and pathological studies was reviewed.

Results: The patient had acute low back pain and radiculopathy with high spiking fever. Therefore, pyogenic discitis was suspected. However, histological diagnosis revealed tophaceous gout.

Conclusions: Tophaceous gout of the spine is very rare. However, when a patient presents with acute back pain and fever, spinal gout should be considered, particularly in a patient with a previous history of hyperuricemia or gout.

Publication types

  • Case Reports

MeSH terms

  • Allopurinol / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Bacterial Infections / diagnosis*
  • Colchicine / therapeutic use
  • Diagnosis, Differential
  • Discitis / diagnosis*
  • Discitis / microbiology
  • Drug Therapy, Combination
  • Gout / complications
  • Gout / pathology*
  • Gout / therapy
  • Gout Suppressants / therapeutic use
  • Humans
  • Intervertebral Disc Displacement / etiology
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / surgery
  • Laminectomy
  • Low Back Pain / etiology
  • Low Back Pain / pathology
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology*
  • Male
  • Middle Aged
  • Radiography
  • Spinal Fusion
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Gout Suppressants
  • Allopurinol
  • Colchicine