Kaler Jaspreet, Mukhtar Osama, Khalid Mazin, Thapa Shivani, Kaler Ravinder, Ting Brandon, Gayam Vijay
Department of Medicine, Interfaith Medical Center, Brooklyn, USA.
Caribbean Medical University, Curacao, Curacao.
J Community Hosp Intern Med Perspect. 2018 Jun 12;8(3):111-114. doi: 10.1080/20009666.2018.1472515. eCollection 2018.
Gout commonly affects peripheral joints and is rarely found in axial joints, such as the spine and sacroiliac joints. We report a case of a patient that presented with quadriparesis who was empirically treated for spinal gout and a review of relevant literature. A 77-year-old male presented with new-onset quadriparesis that developed over 3 days. MRI imaging was suggestive of tophaceous gout of the cervical spine, but our patient refused a spinal biopsy. He was empirically treated with high-dose steroids and his upper and lower extremities weakness started improving within 3 days and resolved completely. Although spinal gout is uncommon, this case indirectly suggests that gout should be kept as a differential diagnosis when faced with back pain or quadriparesis. This case implies that empiric treatment should be considered when radiographic evidence is suggestive of tophaceous gout of the spine.
痛风通常累及外周关节，很少见于脊柱和骶髂关节等中轴关节。我们报告一例表现为四肢瘫痪的患者，该患者接受了脊柱痛风的经验性治疗，并对相关文献进行了综述。一名77岁男性出现新发四肢瘫痪，症状在3天内逐渐发展。MRI成像提示颈椎有痛风石性痛风，但我们的患者拒绝进行脊柱活检。他接受了大剂量类固醇的经验性治疗，其上下肢无力在3天内开始改善并完全消失。虽然脊柱痛风并不常见，但该病例间接表明，当面对背痛或四肢瘫痪时，应将痛风作为鉴别诊断之一。该病例提示，当影像学证据提示脊柱有痛风石性痛风时，应考虑经验性治疗。
