背痛和神经根病的罕见病因——脊柱痛风石：一例报告
A rare cause of back pain and radiculopathy - spinal tophi: a case report.
作者信息
Wan S A, Teh C L, Jobli A T, Cheong Y K, Chin W V, Tan B B
机构信息
Rheumatology Unit, Sarawak General Hospital, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia.
Radiology Department, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia.
出版信息
J Med Case Rep. 2019 Jan 8;13(1):8. doi: 10.1186/s13256-018-1940-4.
BACKGROUND
Gout is a monosodium urate deposition disease which is prevalent worldwide. The usual manifestations are crystal arthropathy and tophi deposition in the soft tissues. Spinal tophi may also occur and are rarely reported, resulting in various clinical manifestations such as back pain, spinal cord compression, radiculopathy, and even mimicking epidural abscess and spondylodiscitis.
CASE PRESENTATION
We report a case of a 42-year-old Chinese man with underlying gout who presented with back pain and radiculopathy. The diagnosis of spinal tophi was unsuspected and he was initially treated for epidural abscess and spondylodiscitis. He underwent a laminectomy and posterolateral fusion during which tophus material was discovered. He recovered and medications for gout were started.
CONCLUSION
Spinal tophi are rare. The diagnosis is difficult and spinal tophi may be mistaken for epidural abscess, spondylodiscitis, or neoplasm.
背景
痛风是一种尿酸钠沉积疾病，在全球范围内普遍存在。其常见表现为晶体性关节病和软组织中痛风石沉积。脊柱痛风石也可能发生，且报道较少，可导致各种临床表现，如背痛、脊髓压迫、神经根病，甚至类似硬膜外脓肿和脊椎椎间盘炎。
病例报告
我们报告一例42岁患有痛风的中国男性，表现为背痛和神经根病。最初未怀疑有脊柱痛风石，他被诊断为硬膜外脓肿和脊椎椎间盘炎并接受了治疗。他接受了椎板切除术和后外侧融合术，术中发现了痛风石物质。他康复后开始服用治疗痛风的药物。
结论
脊柱痛风石罕见。诊断困难，脊柱痛风石可能被误诊为硬膜外脓肿、脊椎椎间盘炎或肿瘤。
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