Spinal gout mimicking paraspinal abscess: A case report

Authors

  • Deepak Udayakumar
  • Tarek Kteleh
  • Sarab Alfata
  • Taha Bali
  • Amy Joseph

DOI:

https://doi.org/10.3941/jrcr.v4i6.332

Keywords:

Axial gout, spinal lesions, paraspinal abscess, uric acid

Abstract

Gout is usually thought of as a peripheral joint disease. However, case reports are available describing gouty lesions in the spine. We report a case of a 51 year old African American woman with no previous history of gout who presented with lower back pain and fever and was found to have multiple small fluid collections in the paraspinal muscles at the L3 to L5 levels on the MRI. She was empirically treated with antibiotics, since the fluid was not accessible for drainage initially. Unsuccessful antibiotic therapy and an episode of peripheral gout during this hospitalization prompted the diagnosis of axial gout as the cause for the paraspinal lesions in this patient. CT guided aspiration of the paraspinal lesions confirmed monosodium urate (gout) crystals under polarized microscopy.

Author Biographies

Deepak Udayakumar

Resident Physician

Division of Internal Medicine

Tarek Kteleh

Clinical Assistant Professor of Medicine

Division of Rheumatology

Sarab Alfata

Clinical Assistant Professor of Family Medicine

Taha Bali

Resident Physician

Division of Neurology

Amy Joseph

Associate Professor of Medicine

Division of Rheumatology

Published

2010-05-23

Issue

Section

Musculoskeletal Radiology