Skip to main content
SpringerLink
Log in

Tophaceous Gout in the Spine Without Prior Hyperuricemia or Tophi in Other Locations

  • Chapter
  • First Online:
Sine Syndromes in Rheumatology

  • 909 Accesses

Abstract

The occurrence of gouty tophi is typical for the chronic stage of gouty arthritis. Tophaceous gout of the spine is rare. It is caused by the deposits of natrium urate crystals into the intervertebral space, intervertebral joints, and fibrous tissue, and it forms epidural masses. This paper presents an overview of published rare cases of sine syndrome in gout – evidence of tophi in the spine in patients previously not treated for gout – without prior documented hyperuricemia, arthritis attacks or tophi in other locations. In these cases, where there is no history of chronic gouty arthritis in a patient with back pain and neurological symptoms, diagnosis is difficult. Computed tomography and magnetic resonance imaging are helpful in the diagnosis, but a definitive diagnosis was established by the histopathological analysis of the material obtained by decompressive laminectomy or needle biopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Pavelka K (2000) Dna (Arthritis urica). In: Rovenský J, Pavelka K et al (eds) Klinická reumatológia. Osveta, Martin, pp 520–533

    Google Scholar 

  2. Varga J, Giampaolo C, Goldenberg DL (1985) Tophaceous gout of the spine in a patient with no peripheral tophi: case report and review of the literature. Arthritis Rheum 28:1312–1315

    Article  PubMed  CAS  Google Scholar 

  3. Van de Laar MA, Van Soesbergen RM, Matricali B (1987) Tophaceous gout of the cervical spine without peripheral tophi (letter). Arthritis Rheum 30:237–238

    Article  PubMed  Google Scholar 

  4. De Das S (1988) Intervertebral disc involvement in gout: brief report. J Bone Joint Surg Br 70-B:671

    Google Scholar 

  5. Fenton P, Young S, Prutis K (1995) Gout of the spine. Two case reports and review of the literature. J Bone Joint Surg Am 77-A:767–771

    Google Scholar 

  6. Thornton FJ, Torreggiani WC, Brennan P (2000) Tophaceus gout of the lumbar spine in a renal transplant patient: a case report and literature review. Eur J Radiol 36:123–125

    Article  PubMed  CAS  Google Scholar 

  7. Pao-Sheng Y, Jui-Feng L, Shin-Yuan C, Shiin-Zong L (2005) Tophaceous gout of the lumbar spine mimicking infectious spondylodiscitis and epidural abscess: MR imaging findings. J Clin Neurosci 12(1):44–46

    Google Scholar 

  8. Kyung-Soo S, Ki-Tack K, Sang-Hun L, Sung-Woo P, Yong-Koo P (2007) Tophaceous gout of the lumbar spine mimicking pyogenic discitis. Spine J 7:94–99

    Article  Google Scholar 

  9. Nygaard HB, Shenoi S, Shukla S (2009) Lower back pain caused by tophaceous gout of the spine. Neurology 73:404

    Article  PubMed  Google Scholar 

  10. Ko K-H, Huang G-S, Chang W-C (2010) Tophaceous gout of the lumbar spine. J Clin Rheumatol 16(4):200

    Article  PubMed  Google Scholar 

  11. Yamamoto M, Tabeya T, Masaki Y et al (2012) Tophaceous gout in the cervical spine. Intern Med 51:325–328

    Article  PubMed  Google Scholar 

  12. Marinho F, Zeitoun-Eiss D, Renoux J, Brasseur J-L, Genestie C, Grenier P (2012) Tophaceous gout of the spine: case report and review of the literature. J Neuroradiol 39(2):123–126

    Article  PubMed  Google Scholar 

  13. Magid SK, Gray GE, Anand A (1981) Spinal cord compression by tophi in a patient with chronic polyarthritis: case report and literature review. Arthritis Rheum 24(11):1431–1434

    Article  PubMed  CAS  Google Scholar 

  14. Resnick D (1996) Gouthy arthritis. In: Resnick D (ed) Bone and joint imaging. W.B. Saunders Company, Philadelphia, pp 395–408

    Google Scholar 

  15. Souza AWS, Fontenele S, Carrete H Jr, Fernandes ARC, Ferrari AJL (2002) Involvement of the thoracic spine in tophaceous gout. A case report. Clin Exp Rheumatol 20:228–230

    PubMed  CAS  Google Scholar 

  16. Gerster JC, Landry M, Dufresne L, Meuwly JZ (2002) Imaging of tophaceous gout: computed tomography provides specific images compared with magnetic resonance imaging and ultrasonography. Ann Rheum Dis 61:52–54

    Article  PubMed  CAS  Google Scholar 

  17. Hsu C-Z, Shih TT, Huang K-M, Chen P-Q, Sheu J-J, Li Z-W (2002) Tophaceous gout of the spine: MRI imaging features. Clin Radiol 57:919–925

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. National Institute of Rheumatic Diseases, Piešťany, Slovakia

    Jozef Rovenský

  2. Institute of Physiotherapy, Balneology and Therapeutic Rehabilitation, University of Saint Cyril and Methodius, Trnava, Piešťany, Slovakia

    Jozef Rovenský

  3. National Institute of Rheumatic Diseases, Nábrežie I. Krasku 4, Piešťany, 921 12, Slovakia

    Jana Sedláková

Authors
  1. Jozef Rovenský
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jana Sedláková
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jozef Rovenský .

Editor information

Editors and Affiliations

  1. National Institute of Rheumatic Diseases, Piešt'any, Slovakia

    Jozef Rovenský

  2. Department of Internal Medicine Rheumatology Unit, Innsbruck Medical University, Innsbruck, Tirol, Austria

    Manfred Herold

  3. First Faculty of Medicine, Thomayer University Hospital with Polyclinic, Charles University, Prague, Czech Republic

    Martina Vašáková

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Wien

About this chapter

Cite this chapter

Rovenský, J., Sedláková, J. (2014). Tophaceous Gout in the Spine Without Prior Hyperuricemia or Tophi in Other Locations. In: Rovenský, J., Herold, M., Vašáková, M. (eds) Sine Syndromes in Rheumatology. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1541-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-1541-1_14

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-1540-4

  • Online ISBN: 978-3-7091-1541-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation