{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T23:39:58Z","timestamp":1783381198017,"version":"3.54.6"},"reference-count":14,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,7,30]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Gout is a common inflammatory arthritis, caused by monosodium urate crystal deposition in the joints. Gout typically affects peripheral joints but less commonly it affects the spine. We report a case of a man in his 30s with chronic gout who presented acutely with thoracic back pain and flaccid paralysis of his lower limbs. CT showed abnormal facet joints at T8\/9 with lucency suggestive of septic arthritis and MRI showed signal changes suggestive of epidural collection. The patient underwent emergency spinal surgery to evacuate the collection, followed by broad-spectrum antibiotic treatment. Cultures were negative; however, histopathology was suggestive of gout tophi. The patient was subsequently treated for spinal gout with prednisolone, allopurinol and colchicine and saw significant improvement in symptoms though he sustained a complete spinal cord injury. This case demonstrates that spinal gout is an important differential to consider in patients with chronic gout, presenting with acute back pain.<\/jats:p>","DOI":"10.1136\/bcr-2023-256360","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T11:45:35Z","timestamp":1691149535000},"page":"e256360","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Tophaceous spinal gout in a young man with complete spinal cord injury"],"prefix":"10.1136","volume":"16","author":[{"given":"Francois","family":"Okoroafor","sequence":"first","affiliation":[{"name":"Neurosurgery Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorfina","family":"Ghazali","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debapriya","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"2025082710593376000_16.8.e256360.1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204463"},{"key":"2025082710593376000_16.8.e256360.2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-7-200510040-00009"},{"key":"2025082710593376000_16.8.e256360.3","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1016\/j.semarthrit.2020.04.008","article-title":"Gout epidemiology and comorbidities","volume":"50","author":"Singh","year":"2020","journal-title":"Semin Arthritis Rheum"},{"key":"2025082710593376000_16.8.e256360.4","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1093\/rheumatology\/kex250","article-title":"The British society for rheumatology guideline for the management of gout","volume":"56","author":"Hui","year":"2017","journal-title":"Rheumatology (Oxford)"},{"key":"2025082710593376000_16.8.e256360.5","doi-asserted-by":"crossref","first-page":"4135","DOI":"10.1016\/j.radcr.2022.08.009","article-title":"Spinal gout diagnosed by dual-energy CT: a case report","volume":"17","author":"Brahmbhatt","year":"2022","journal-title":"Radiol Case Rep"},{"key":"2025082710593376000_16.8.e256360.6","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000015265","article-title":"Diagnostic challenges of spinal gout","volume":"98","author":"Ma","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"2025082710593376000_16.8.e256360.7","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080374"},{"key":"2025082710593376000_16.8.e256360.8","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.111517"},{"key":"2025082710593376000_16.8.e256360.9","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.056812"},{"key":"2025082710593376000_16.8.e256360.10","doi-asserted-by":"crossref","first-page":"766","DOI":"10.5312\/wjo.v7.i11.766","article-title":"Spinal gout: A review with case illustration","volume":"7","author":"Elgafy","year":"2016","journal-title":"World J Orthop"},{"key":"2025082710593376000_16.8.e256360.11","article-title":"A man with intractable back pain, spondylodiscitis: a case report of uncommon site of spinal gout","volume":"13","author":"Karam","year":"2021","journal-title":"Cureus"},{"key":"2025082710593376000_16.8.e256360.12","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-018-1940-4","article-title":"A rare cause of back pain and radiculopathy \u2013 spinal tophi: a case report","volume":"13","author":"Wan","year":"2019","journal-title":"J Med Case Rep"},{"key":"2025082710593376000_16.8.e256360.13","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afq070","article-title":"Lucent lesions of the spine--a case of spinal gout","volume":"39","author":"Murphy","year":"2010","journal-title":"Age Ageing"},{"key":"2025082710593376000_16.8.e256360.14","doi-asserted-by":"crossref","unstructured":"Kirollos R , Helmy A , Thomson S , et al . 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