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Cervical Myelopathy Secondary to Gout: Case Report[*]Article in several languages: português | English
Gout is a crystalline arthropathy frequent in the population, but gouty spondyloarthropathy, also called axial gout, is uncommon. The current case report presents a rare case of cervical myelopathy secondary to axial gout. A 50-year-old female patient, without previous pathologies, presented with loss of strength, altered sensitivity, and pyramidal release for 2 years. The computed tomography showed a lytic image in the spinous process of C7, and signs of myelopathy with myelomalacia on magnetic resonance imaging of the cervical spine. After the surgical procedure and biopsy of the material, the diagnosis was gout, and treatment for the pathology was started, with complete improvement of the condition. The diagnosis of axial gout should be included in the spectrum of the differential diagnosis of diseases that affect the spine. Although gouty spondyloarthritis (or spondylitis) is uncommon, there is an underestimated occurrence due to the lack of investigation of the cases. The early diagnosis and treatment of the pathology can prevent patients from presenting complications of the disease, as reported in the present study.
* Work developed at the Department of Orthopedics and Traumatology of Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Received: 12 August 2019
Accepted: 12 December 2019
02 April 2020 (online)
© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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- 1 Hasegawa EM, de Mello FM, Goldenstein-Schainberg C, Fuller R. Gout in the spine. Rev Bras Reumatol 2013; 53 (03) 296-302
- 2 Toprover M, Krasnokutsky S, Pillinger MH. Gout in the Spine: Imaging, Diagnosis, and Outcomes. Curr Rheumatol Rep 2015; 17 (12) 70
- 3 Fernandes ED, Bergamaschi SB, Rodrigues TC. et al. Aspectos relevantes do diagnóstico e seguimento por imagem na gota. Rev Bras Reumatol 2017; 57 (01) 64-72
- 4 Kersley GD, Mandel L, Jeffrey MR. Gout; an unusual case with softening and subluxation of the first cervical vertebra and splenomegaly. Ann Rheum Dis 1950; 9 (04) 282-304
- 5 Koskoff YD, Morris LE, Lubic LG. Paraplegia as a complication of gout. J Am Med Assoc 1953; 152 (01) 37-38
- 6 Ng W, Sin CH, Wong CH, Chiu WF, Chung OM. Unusual Presentation of Spinal Gout: 2 Cases Report and Literature Review. J Orthop Case Rep 2017; 7 (06) 50-54
- 7 Volkov A, Rhoiney DL, Claybrooks R. Tophaceous Gout of the Lumbar Spine: Case Report and Review of the Literature. Turk Neurosurg 2015; 25 (06) 954-958
- 8 Andrés M, Vela P, Volar LC, Avilés Y, Pascual E. Back pain due to lumbar gouty flare--a prospective diagnosis. J Rheumatol 2013; 40 (08) 1459-1460
- 9 King JC, Nicholas C. Gouty arthropathy of the lumbar spine: a case report and review of the literature. Spine 1997; 22 (19) 2309-2312
- 10 Shidham VM, Galindo L, Gupta D, Jhala N, Shidham G. Urate crystals in tissue: A novel staining method for formalin-fixed, paraffin-embedded sections. Lab Med 1998; 29: 109-113