A case report of thoracic epidural tophaceous gout

Abstract

A 45-year-old man with severe hyperuricemia developed back pain and difficulty walking. Magnetic resonance imaging (MRI) revealed a thoracic epidural mass lesion compressing the spinal cord, and CT showed calcification in the mass. Decompression and fusion surgery were performed, and the pathological diagnosis was that of spinal tophaceous gout. Although motor function improved partially, severe spasticity persisted. Retrospectively, the calcified mass in the thoracic spine had been identifiable on CT two months before the onset of back pain. If patients with poor control of hyperuricemia complain of back pain, CT is highly recommended to rule out spinal tophaceous gout.