SPINAL GOUT: A REPORT OF THREE CASES AND LITERATURE REVIEW

Abstract

Objective To investigate the features of patients with spinal gout, and to improve diagnostic accuracy among clinicians. Methods Related clinical data were collected from three patients with spinal gout who were admitted to our hospital, and a literature review was performed. Results All three patients had previously been diagnosed with gout and received surgical treatment for the symptoms of cervical or lumbar nerve involvement. Patient 1 had a normal level of serum uric acid (sUA), while patients 2 and 3 had an increase in the level of sUA. For patients 1 and 3, preoperative spinal magnetic resonance showed decreased T2WI signal, and patient 1 had a high possibility of inflammation of the cervical vertebrae C3-7, while patient 3 had circular high-density shadow and clear sclerotic edge in the cervical vertebrae C4-6. Postoperative pathological examination showed gouty granuloma in patients 1 and 2, and patient 3 was found to have chronic inflammation with hyaline change, granulomatous hyperplasia, and multinucleated giant cell reaction in fibrovascular tissue. All three patients achieved varying degrees of relief of nerve compression symptoms after surgery. Conclusion The possibility of spinal gout should be considered if patients with gout have nerve compression symptoms and the features of typical bone damage in gout found by radiological examination, and it is necessary to complete the examination of sUA and urate crystal deposition in time, confirm the diagnosis of spinal gout before surgery, and make adequate preparation before surgery.

Keywords

• gout|spine|magnetic resonance imaging|surgical procedures, operative|granuloma|case reports