Hong Kong Med J 2009;15:143-5 | Number 2, April 2009
Thoracic spinal gout mimicking metastasis
Augustine TS Chan, John LY Leung, Alan NL Sy, Wendy WC Wong, KY Lau, WT Ngai, VW Tang
Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
Gout is a common metabolic disease but spinal gout is rare. We report a case of gouty arthritis affecting the thoracic spine in a 76-year-old male patient with a long history of tophaceous gout who presented with bilateral lower limb weakness. Magnetic resonance imaging of his thoracic spine revealed erosions in the left pedicles of T8 and T10. The initial imaging diagnosis was metastatic disease. A computed tomography-guided biopsy of the T10 lesion was performed and confirmed the diagnosis of gout. We advocate the use of computed tomography-guided fine-needle aspiration/biopsy for diagnosing spinal gout because the imaging features are non-specific, metastasis and spondylodiscitis being important mimickers.
Key words: Biopsy, fine-needle; Gout; Spinal diseases; Thoracic vertebrae; Tomography, X-ray computed
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