[Tophaceous gout of the cervical spine, causing cord compression. Case report and review of the literature].
We present the case of a 74-year-old patient with long-standing gout who developed C4-C5 tophaceous gout causing cord compression. The patient had undergone 4 years earlier for a disco-osteophytic cord compression (anterior C4-C5 and C5-C6 discectomy). When admitted, the patient presented quadriparesia which had developed during the previous week in association with acute tophaceous gout on the knees, and the metarsophalangeal articulations, in the context of a bronchial infection. The diagnosis of spondylodiscitis was initially retained because of the clinical features of severe infection and the radiological data (C4-C5 cord compression, with anterior epidural lesions in MRI). The intervention allowed decompression and pathological diagnosis of tophaceous gout. Spinal gout is well-known, and very rarely responsible for cord compression: only 15 cases of cervical gout have been described in the literature. Radiological findings are not specific, and treatment is surgical in the event of medullar compression despite medical treatment.
Diaz
A
A
Service de Neurochirurgie, CH Sud-Réunion, 97448 Saint-Pierre Cedex. Alain.Diaz@wanadoo.fr
Porhiel
V
V
Sabatier
P
P
Taha
S
S
Ragragui
O
O
Comoy
J
J
Leriche
B
B
D000368:Aged; D015210:Arthritis, Gouty / Q000150:complications*; D006801:Humans; D008297:Male; D013117:Spinal Cord Compression / Q000209:etiology*; D013122:Spinal Diseases / Q000150:complications*