Lumbar radiculopathy secondary to gouty tophi in the filum terminale in a patient without systemic gout: case report

Neurosurgery. 2000 Apr;46(4):986-8. doi: 10.1097/00006123-200004000-00042.

Abstract

Objective and importance: Gouty arthritis and gouty tophi of the spine are very rare. We present a patient with the clinical manifestations of an intradural tumor and histologically proven gouty deposits in the filum terminale.

Clinical presentation: The patient presented with typical symptoms of lumbar radiculopathy and neurogenic claudication. There was no evidence of peripheral gout.

Intervention: Imaging studies, including computed tomography and magnetic resonance imaging, demonstrated a 1-cm, round, intradural, calcified lesion at the L3 vertebral level, causing moderate spinal stenosis. The patient underwent a two-level laminectomy and removal of the mass. A pathological examination of the specimen revealed gouty deposits in the region of the filum terminale.

Conclusion: Spinal involvement in gout is very rare, and intradural gouty deposits have not been previously described. Intradural gout should be considered in the differential diagnosis of intradural masses.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Gout / complications*
  • Gout / diagnosis
  • Gout / surgery
  • Humans
  • Laminectomy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Radiculopathy / etiology*
  • Spinal Diseases / complications*
  • Spinal Diseases / diagnosis
  • Spinal Diseases / surgery
  • Spinal Stenosis / etiology
  • Spine / pathology
  • Tomography, X-Ray Computed