Extradural Tophaceous Gout of Lumbosacral Spine Report of a Case

發生於腰薦椎硬脊膜外之結石性痛風：病例報告

郭岱宗(Tai-Tzung Kuo) ； 蔡承嘉(Chen-Chia Tsai) ； 張丞圭(Cheng-Kuei Chang) ； 蔣明富(Ming-Fu Chiang)

《Formosan Journal of Surgery》 40卷3期 (2007/06) Pp. 121-126

https://doi.org/10.29833/FJS.200706.0004

摘要

雖然痛風性關節炎為一常見之代謝異常性疾病且痛風性結石可能會陳積於關節或關節附近之結締組織，但其脊柱侵犯仍屬於相當少見。我們報告一例已知有長期不規則藥物控制之周邊多發性痛風之病患所併發之腰薦椎脊柱痛風，以亞急性左下肢神經痛表現，而臨床上表現類似感染性發炎。病患接受了手術治療，而病理報告證實結石性痛風沉積。我們針對臨床、放射影像及病理特徵進行討論，並且強調對於已知有周邊痛風之患者同時表現出有脊椎神經壓迫之症狀時，吾人必須將脊柱痛風列入鑑別診斷當巾而不致造成延誤。

並列摘要

Although gouty arthritis is a common metabolic disorder, and the gouty tophi may be deposited in the joints and juxtaarticular connective tissue, its affliction of the axial spine is relatively rare. We present therefore a rare case of lumbosacral extradural spinal gout. The patient had a long history of peripheral polyarticular gout without regular medical control. The clinical manifestation was subacute left radiculopathy which mimicked an infectious process. Surgical decompression was performed and the histopathological examination showed tophaceous gout deposition. The clinical, radiological and pathological features are discussed. If a gout patient develops symptoms indicative of spinal cord compression, spinal gout should be included in differential diagnosis.

並列關鍵字

extradural ； tophaceous gout