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Table 1 Case Reports of Tophaceous Gout in the Cervical Spine

From: Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review

  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
  1. UA: uric acid, CRP: C-reactive protein, N.D.: not described, CBN: cervicobrachial neuralgia