A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout

Gout typically affects the peripheral joints but uncommonly can involve the axial skeleton and rarely the intervertebral discs. We present a rare case of gouty spondylodiscitis affecting the intervertebral disc in the lumbar spine. Our patient with a gout history not on any maintenance therapy prese...

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Autores principales: Karam, Imad, Ahmad, Anam, Baker, Donica L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372669/
https://www.ncbi.nlm.nih.gov/pubmed/34430096
http://dx.doi.org/10.7759/cureus.16480
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author Karam, Imad
Ahmad, Anam
Baker, Donica L
author_facet Karam, Imad
Ahmad, Anam
Baker, Donica L
author_sort Karam, Imad
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description Gout typically affects the peripheral joints but uncommonly can involve the axial skeleton and rarely the intervertebral discs. We present a rare case of gouty spondylodiscitis affecting the intervertebral disc in the lumbar spine. Our patient with a gout history not on any maintenance therapy presented intractable right-sided back pain radiating to the right lower extremity. Computed tomography scan findings were consistent with spondylosis, while magnetic resonance imaging showed concern of infectious discitis. Initially, he was treated for infectious discitis with IV antibiotics. Biopsy of the L5-S1 disc space revealed monosodium urate crystals, confirming the diagnosis of gouty spondylodiscitis. He was managed with IV dexamethasone and recovered well on a tapering dose of steroids and colchicine followed by allopurinol once acute flare resolved.
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spelling pubmed-83726692021-08-23 A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout Karam, Imad Ahmad, Anam Baker, Donica L Cureus Internal Medicine Gout typically affects the peripheral joints but uncommonly can involve the axial skeleton and rarely the intervertebral discs. We present a rare case of gouty spondylodiscitis affecting the intervertebral disc in the lumbar spine. Our patient with a gout history not on any maintenance therapy presented intractable right-sided back pain radiating to the right lower extremity. Computed tomography scan findings were consistent with spondylosis, while magnetic resonance imaging showed concern of infectious discitis. Initially, he was treated for infectious discitis with IV antibiotics. Biopsy of the L5-S1 disc space revealed monosodium urate crystals, confirming the diagnosis of gouty spondylodiscitis. He was managed with IV dexamethasone and recovered well on a tapering dose of steroids and colchicine followed by allopurinol once acute flare resolved. Cureus 2021-07-19 /pmc/articles/PMC8372669/ /pubmed/34430096 http://dx.doi.org/10.7759/cureus.16480 Text en Copyright © 2021, Karam et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Karam, Imad
Ahmad, Anam
Baker, Donica L
A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout
title A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout
title_full A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout
title_fullStr A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout
title_full_unstemmed A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout
title_short A Man With Intractable Back Pain, Spondylodiscitis: A Case Report of Uncommon Site of Spinal Gout
title_sort man with intractable back pain, spondylodiscitis: a case report of uncommon site of spinal gout
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8372669/
https://www.ncbi.nlm.nih.gov/pubmed/34430096
http://dx.doi.org/10.7759/cureus.16480
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