Journal article
Foraminal stenosis and radiculopathy secondary to tophaceous gout: illustrative case
Journal of neurosurgery. Case lessons, v 6(26), 23298
25 Dec 2023
PMID: 38145559
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND Tophaceous gout is a severe form of gout that results in the formation of large nodules, or tophi, in the affected joints and surrounding tissues. Gouty tophi in the spine have a constellation of presentations that often mimic other pathologies and may not be easily discernable from more common pathologic processes. OBSERVATIONS A 47-year-old female with a history of chronic renal disease, obesity, gout, inflammatory polyarthritis, and multiple sclerosis presented with 6 months of low-back pain and lumbar radiculopathy affecting the right lower extremity. A lumbar magnetic resonance imaging study revealed right foraminal stenosis and spondylolisthesis at levels L4-5. An intraspinal extradural mass was noted adjacent to the traversing right L5 and exiting right L4 nerve roots. A bilateral decompressive laminectomy, facetectomy, and foraminotomy of L4-5 was performed. A calcific, chalky-white mass was discovered in the foramen, and pathology determined the specimen to be a gout tophus. Postoperatively, the patient endorsed the resolution of her preoperative symptoms, which have not returned on follow-up. LESSONS Reports of gouty depositions compressing the spinal cord in the current literature are relatively rare. Although the diagnosis of gouty tophi can only be confirmed histologically, patient history may serve as a helpful diagnostic tool.
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Details
- Title
- Foraminal stenosis and radiculopathy secondary to tophaceous gout: illustrative case
- Creators
- Patrick Chang - Drexel Univ, Coll Med, Philadelphia, PA 19104 USABrandon C. Rogowski - Drexel UniversityKhaled Abdel Aziz - College Station Medical CenterRosh Bharthi - College Station Medical CenterLance Valls - Allegheny Hlth Network, Dept Neurosurg, Pittsburgh, PA USANathan Esplin - Allegheny Hlth Network, Dept Neurosurg, Pittsburgh, PA USARichard W. Williamson - Allegheny Hlth Network, Dept Neurosurg, Pittsburgh, PA USA
- Publication Details
- Journal of neurosurgery. Case lessons, v 6(26), 23298
- Publisher
- Amer Assoc Neurological Surgeons
- Number of pages
- 4
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001408638200005
- Scopus ID
- 2-s2.0-85185331266
- Other Identifier
- 991022207058404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery