title: Tophaceous gout of the lumbar spine mimicking pyogenic discitis.
abstract: BACKGROUND
  Gout of the spine is very rare. Forty-one cases of gout affecting the spine have been reported.
  
  
  OBJECTIVE
  To present a patient with tophaceous gout of the lumbar spine mimicking pyogenic discitis.
  
  
  METHODS
  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.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Kyung-Hee University, Seoul, Korea. sks111@khmc.or.kr
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Suk
authors.forename: Ki-Tack
authors.initials: KT
authors.lastname: Kim
authors.forename: Sang-Hun
authors.initials: SH
authors.lastname: Lee
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Yong-Koo
authors.initials: YK
authors.lastname: Park
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis*; D003078:Colchicine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis* / Q000382:microbiology; D004359:Drug Therapy, Combination; D006073:Gout / Q000150:complications / Q000473:pathology* / Q000628:therapy; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000209:etiology / Q000473:pathology / Q000601:surgery; D007796:Laminectomy; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013123:Spinal Fusion; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D000493:Allopurinol; D003078:Colchicine