期刊
SURGICAL NEUROLOGY
卷 67, 期 1, 页码 65-73出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.surneu.2006.03.038
关键词
spine; gout; management; renal transplant
Background: Gout in the axial spine is rare. We present a case report on a renal transplant patient who developed fever and acute back pain at the L5 through SI level secondary to sodium urate deposits. We review the literature on this rare disease and propose a management algorithm based on a resulting analysis. Case Description: A 37-year-old man with a history of gout and a renal transplant for IgA nephropathy presented with acute back pain and fever without evidence of neurological deficits. Magnetic resonance imaging revealed a uniformly contrast-enhancing infiltrative process involving the right pedicle, lamina, and inferior facet of the L5 vertebra. Computed tomography guided needle biopsy revealed a friable white tissue consistent with sodium urate crystals. Conservative treatment with steroids and narcotics was used with good symptomatic relief. Conclusion: Although few cases of gout involving the spine have been reported, its prevalence is likely grossly underestimated. Most patients have a history of gout and have elevated levels of serum urate level on presentation. The disease most commonly involves the lumbar spine. Patients usually have neurological deficits on presentation, and surgical decompression produces favorable outcomes. However, conservative medical management is appropriate for those with back pain only. Aggressive control of hyperuricemia is essential regardless of the method of treatment. (c) 2007 Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据