Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review
Abstract Background Gout in spine is rare and commonly mimics some infectious or tumoral lesions, the differentiation of spinal gout from other diseases is not always easy. We report a case of gout involved cervical disc and adjacent vertebral endplates whose etiology was initially not determined. C...
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2813-8 |
| _version_ | 1818133680695017472 |
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| author | Suying Zhou Yundan Xiao Xin Liu Yi Zhong Haitao Yang |
| author_facet | Suying Zhou Yundan Xiao Xin Liu Yi Zhong Haitao Yang |
| author_sort | Suying Zhou |
| collection | DOAJ |
| description | Abstract Background Gout in spine is rare and commonly mimics some infectious or tumoral lesions, the differentiation of spinal gout from other diseases is not always easy. We report a case of gout involved cervical disc and adjacent vertebral endplates whose etiology was initially not determined. Compared with the previous published 10 similar cases, this case displayed a complete and continuous image data with higher image quality and resolution than before. So we give a brief literature review for concerning cervical gout, with the emphasis on the discussion of radiological findings. Case presentation A 50-year-old male with a 5-year history of neck and shoulder pain had muscle atrophy and weakness in both arms. Physical examination revealed multiple tophi were seen in left wrist, both feet and knee; bilateral superficial sensory declined below level of mastoid portion and the muscle strengths of limbs decreased. Laboratory findings showed hyperuricemia and the C-reactive protein level was very high. Imaging studies including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed abnormality of the C5–6 intervertebral disc and irregular osteolytic destruction of both adjacent C5–6 endplates, narrowing of C5–6 disc space and swelling of prevertebral soft tissue. Under the circumstance of the lesions being not determined and nerve root symptoms, surgical treatment was performed and pathological examination of the specimen revealed deposited uric acid crystals surrounded by granulomatous inflammation. After surgery combined with pharmaceutical and rehabilitation treatment, the muscle strengths of limbs, the pain of neck and shoulder and the level of serum uric acid were all improved. Conclusions Cervical spinal gout involving the disc and adjacent vertebral endplates is uncommon and may misunderstand infectious spondylodiscitis. Physician and radiologist should take the gouty spondylitis into account with a combination with previous history and clinical manifestations when encountering with such this condition. |
| first_indexed | 2024-12-11T08:56:35Z |
| format | Article |
| id | doaj.art-dc269f722d6140758513faea8dd7beff |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-11T08:56:35Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-dc269f722d6140758513faea8dd7beff2022-12-22T01:13:52ZengBMCBMC Musculoskeletal Disorders1471-24742019-09-012011810.1186/s12891-019-2813-8Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature reviewSuying Zhou0Yundan Xiao1Xin Liu2Yi Zhong3Haitao Yang4Department of Radiology, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, the First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, the First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Gout in spine is rare and commonly mimics some infectious or tumoral lesions, the differentiation of spinal gout from other diseases is not always easy. We report a case of gout involved cervical disc and adjacent vertebral endplates whose etiology was initially not determined. Compared with the previous published 10 similar cases, this case displayed a complete and continuous image data with higher image quality and resolution than before. So we give a brief literature review for concerning cervical gout, with the emphasis on the discussion of radiological findings. Case presentation A 50-year-old male with a 5-year history of neck and shoulder pain had muscle atrophy and weakness in both arms. Physical examination revealed multiple tophi were seen in left wrist, both feet and knee; bilateral superficial sensory declined below level of mastoid portion and the muscle strengths of limbs decreased. Laboratory findings showed hyperuricemia and the C-reactive protein level was very high. Imaging studies including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed abnormality of the C5–6 intervertebral disc and irregular osteolytic destruction of both adjacent C5–6 endplates, narrowing of C5–6 disc space and swelling of prevertebral soft tissue. Under the circumstance of the lesions being not determined and nerve root symptoms, surgical treatment was performed and pathological examination of the specimen revealed deposited uric acid crystals surrounded by granulomatous inflammation. After surgery combined with pharmaceutical and rehabilitation treatment, the muscle strengths of limbs, the pain of neck and shoulder and the level of serum uric acid were all improved. Conclusions Cervical spinal gout involving the disc and adjacent vertebral endplates is uncommon and may misunderstand infectious spondylodiscitis. Physician and radiologist should take the gouty spondylitis into account with a combination with previous history and clinical manifestations when encountering with such this condition.http://link.springer.com/article/10.1186/s12891-019-2813-8SpineCervicalGoutRadiology |
| spellingShingle | Suying Zhou Yundan Xiao Xin Liu Yi Zhong Haitao Yang Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review BMC Musculoskeletal Disorders Spine Cervical Gout Radiology |
| title | Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review |
| title_full | Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review |
| title_fullStr | Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review |
| title_full_unstemmed | Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review |
| title_short | Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review |
| title_sort | gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging case report and literature review |
| topic | Spine Cervical Gout Radiology |
| url | http://link.springer.com/article/10.1186/s12891-019-2813-8 |
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