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Войти в исследования Medicine · 2022
Intraspinal extradural gout tophus in the lumbar vertebral canal: Case reports.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Wu Zhiqiang, Liu Chunhua, Dai Kehui, Zheng Chunfeng
Аннотация
RATIONALE: Intraspinal gout tophus in the lumbar vertebral canal associated with gouty arthritis is rare. We present 2 cases with the first manifestations of a sequestrated intervertebral disc and an extradural tumor, and histopathologically proven to be gouty deposits in the lumbar vertebral canal.
PATIENT CONCERNS: The 2 patients presented with typical radiculopathy symptoms and a positive straight leg raise. In 1 case, there was weakness of the left toe extensors, with a positive left femoral nerve traction test. Additionally, the left patellar tendon reflex was weak. In the other patient who was unable to walk, there was a sensory deficit in the saddle distribution.
DIAGNOSIS: Histopathological examination of the specimens taken from the operation confirmed the presence of gouty deposits.
INTERVENTIONS: Posterior decompression was performed in these 2 cases, and chalky-white materials were identified in the lumbar vertebral canal.
OUTCOMES: No evidence of neoplasm, infection, or synovial cyst was found.
LESSONS: Definitive diagnosis of intraspinal extradural gout tophus, mimicking a sequestrated intervertebral disc or an extradural tumor, may be difficult. The initial suspicion of intraspinal gouty deposits, based on the diagnostic/management algorithm, may effectively avoid incorrect diagnosis via a less invasive procedure than explorative laminectomy.
PATIENT CONCERNS: The 2 patients presented with typical radiculopathy symptoms and a positive straight leg raise. In 1 case, there was weakness of the left toe extensors, with a positive left femoral nerve traction test. Additionally, the left patellar tendon reflex was weak. In the other patient who was unable to walk, there was a sensory deficit in the saddle distribution.
DIAGNOSIS: Histopathological examination of the specimens taken from the operation confirmed the presence of gouty deposits.
INTERVENTIONS: Posterior decompression was performed in these 2 cases, and chalky-white materials were identified in the lumbar vertebral canal.
OUTCOMES: No evidence of neoplasm, infection, or synovial cyst was found.
LESSONS: Definitive diagnosis of intraspinal extradural gout tophus, mimicking a sequestrated intervertebral disc or an extradural tumor, may be difficult. The initial suspicion of intraspinal gouty deposits, based on the diagnostic/management algorithm, may effectively avoid incorrect diagnosis via a less invasive procedure than explorative laminectomy.