Lucent lesions of the spine—a case of spinal gout

摘要

Chronic tophaceous gout is a common metabolic disorder in older people, and although spinal involvement is rare, it can mimic other disease processes [1]. Spinal gout can present with back pain, lytic vertebral lesions or neurological compromise.nnAn 82-year-old man was admitted with a 15-kg weight loss and 3 months of increasing back pain. He had multiple gouty tophi on both hands. Radiology demonstrated lucent spinal lesions which were initially thought to represent multiple myeloma or metastases. Tissue diagnosis confirmed spinal gout.nnTophaceous gout of the spine remains rare yet can mimic metastatic and infective spinal lesions. It is therefore an important differential diagnosis in patients presenting with back pain and where imaging has identified lytic lesions of the spine. Early diagnosis is important as aggressive medical management of gout can reduce morbidity and reduce the likelihood of spinal surgery [2].