Table 1 Case Reports of Tophaceous Gout in the Cervical Spine
Age, gender | Known gout | Symptoms | Imaging findings | Lab test results | Histology | Outcome | Co-morbidities/ History | |
|---|---|---|---|---|---|---|---|---|
1. Duprez TP | 59, M | + | Progressive impairment of walking | MRI: involvement of C3–6 | UA: 9.9 mg/dl | At surgery: gouty tophi in the posterior longitudinal ligament | Improvement after surgery | N. D. |
2. Yen HL | 68, M | + | Neck pain and numbness and weakness of all four limbs | MRI: narrowing of the thecal sac at the C3–6 levels | UA: 12.1 mg/dl | Biopsy: presence of monosodium urate crystals | Improvement after surgery | Diabetes mellitus |
3. Cabot J | 76, F | N.D. | Neck pain and upper limb weakness | MRI: arthritis of the right C4–5 facet joint and the C7-T1 left facet joint | UA: 12.2 mg/dl CRP: 147 mg/l | CT-guided aspiration: monosodium urate crystals | Improvement with colchicine therapy | Diabetes mellitus, diabetic nephropathy, hypertension |
4. Dharmadhikari R | 66, F | – | Weakness of all four limbs, urinary continence | MRI: involvement of C3–6 and cord compression | UA: 12.6 mg/dl | Biopsy: presence of gout crystals | Death caused by bronchopneumonia after surgery | Atrial fibrillation, hypertension, moderate cardiac dysfunction |
5. Yamamoto M | 58, F | + | Polyarticular disability | CT: involvement of C4–7 | UA: 9.4 mg/dl CRP: 85.5 mg/l | – | Improvement with medication | Chronic arthritis |
6. Wendling, D | 54, M | + | Inflammatory neck pain and CBN | MRI: involvement of C5 and C6 | UA: 11.5 mg/dl CRP: 5 mg/l | N.D. | Full recovery with colchicine therapy | Hypercholesterolemia |
7. Wendling, D | 72, M | + | Acute neck pain, knee arthritis | MRI: C5-C6 discitis | UA: 4.1 mg/dl CRP: 93 mg/l | N.D. | Full recovery with colchicine therapy | Hypertension |
8. Nunes EA | 59, M | N.D. | Occipital pain, cervicalgia | MRI: involvement of the odontoid process | UA: 8.6 mg/dl | Biopsy: inflammatory granuloma and monosodium urate crystals | Full recovery after surgery | Polyarthritis, hypertension |
9. Ng W | 66, M | N.D. | Neck pain, weakness of upper limbs | MRI: involvement of C4–6 and cord compression | UA: 7.6 mg/dl CRP: 7.7 mg/l | Biopsy: presence of urate crystals | Improvement after surgery and medication | Diabetes mellitus, hypertension, chronic renal insufficiency |
10. Cheng CW | 23, M | + | Back pain, weakness of the lower limbs | MRI: epidural collection from C4 to T10 | UA: 14.6 mg/dl CRP: 122.5 mg/l | Biopsy: inflammatory granuloma, urate crystals | Full recovery after surgery and medication | Chronic renal disease. Transverse myelitis |