[Tophaceous gout of the lumbar spine in a patient without systemic gout or normouricaemia]

Abstract

Gout is a common metabolic disorder typically diagnosed in peripheral joints. Tophaceous deposits in the lumbar spine is a very rare condition with very few cases reported in the literature. We present a case of tophaceous gout that originated in the lumbar spine in a patient with normal uric acid blood levels. The following case report concerns a 52-year-old patient with low back pain, left sciatica and numbness in the left leg. Serum uric acid levels were within normal range. MRI and bone scan images suggested an inflammatory-infectious process focussed at L4. After an L4-L5 decompressive laminectomy, histological examination revealed tissue infiltrated with mature plasma cells with negatively birefringent crystals using polarised light consistent with urate deposits.

Keywords: Ciática; Columna lumbar; Dolor lumbar; Low back pain; Lumbar spine; Sciatica; Tofo gotoso; Tophaceous gout.