{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:24Z","timestamp":1753893324677,"version":"3.41.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Gout is a common disease; however, a gout tophus occurring within the spinal dura is exceedingly rare, with only two cases reported to date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report the case of a 70-year-old female who presented with lower back pain, right radicular pain, and numbness in the perineal area. Magnetic resonance imaging and computed tomography scans revealed a calcified intradural lesion at the L3 level. The diagnosis of the lesion was not definitive because the patient had no history of gout or manifestations of systemic gout. Surgical removal of the intradural lesion followed by pathological examination confirmed gouty tophi. The postoperative recovery was good, and the patient experienced substantial relief from pain and numbness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the third documented case of gout tophi occurring within the spinal dura. In a literature review, it was found that none of these three patients with intradural gouty tophi had systemic gout manifestations or hyperuricemia, which is a crucial finding. As it is challenging to diagnose intradural gout, awareness among physicians must be increased to optimize the treatment of, and outcomes for, these patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1472886","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T06:48:54Z","timestamp":1739170134000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Intradural gout tophi without systemic gout symptoms"],"prefix":"10.3389","volume":"12","author":[{"given":"Peidong","family":"Qing","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiming","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaoqun","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongda","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengxin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haitao","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yehui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youpeng","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1038\/s41584-020-0441-1","article-title":"Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors","volume":"16","author":"Dehlin","year":"2020","journal-title":"Nat Rev Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"759","DOI":"10.3899\/jrheum.130690","article-title":"Longterm safety and effectiveness of the anti-interleukin 6 receptor monoclonal antibody tocilizumab in patients with systemic juvenile idiopathic arthritis in Japan","volume":"41","author":"Yokota","year":"2014","journal-title":"J Rheumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.amjmed.2006.02.044","article-title":"Updates in the management of gout","volume":"120","author":"Keith","year":"2007","journal-title":"Am J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.rdc.2014.01.006","article-title":"Structural joint damage in gout","volume":"40","author":"Chhana","year":"2014","journal-title":"Rheum Dis Clin North Am"},{"key":"B5","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1007\/s11926-015-0547-7","article-title":"Gout in the spine: imaging, diagnosis, and outcomes","volume":"17","author":"Toprover","year":"2015","journal-title":"Curr Rheumatol Rep"},{"key":"B6","first-page":"986","article-title":"Lumbar radiculopathy secondary to gouty tophi in the filum terminale in a patient without systemic gout: case report","volume":"46","author":"Paquette","year":"2000","journal-title":"Neurosurgery"},{"key":"B7","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1007\/s00586-015-4309-z","article-title":"Gout tophus on an intradural fascicle: a case description","volume":"25","author":"Willner","year":"2016","journal-title":"Eur Spine J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1038\/nrrheum.2015.91","article-title":"Global epidemiology of gout: prevalence, incidence and risk factors","volume":"11","author":"Kuo","year":"2015","journal-title":"Nat Rev Rheumatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"942062","DOI":"10.3389\/fsurg.2022.942062","article-title":"Carpal tunnel syndrome caused by tophi deposited under the epineurium of the median nerve: a case report","volume":"9","author":"Zhang","year":"2022","journal-title":"Front Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1282202","DOI":"10.3389\/fsurg.2023.1282202","article-title":"Carpal tunnel syndrome caused by tophi in the superficial flexor tendon: a case report","volume":"10","author":"Hao","year":"2023","journal-title":"Front Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1353116","DOI":"10.3389\/fsurg.2024.1353116","article-title":"Case report: a rare case of bilateral middle ear tophaceous gout","volume":"11","author":"Camurdan","year":"2024","journal-title":"Front Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1186\/ar1907","article-title":"Epidemiology, risk factors, and lifestyle modifications for gout","volume":"8","author":"Saag","year":"2006","journal-title":"Arthritis Res Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"3697","DOI":"10.1007\/s00586-023-07942-8","article-title":"Patient characteristics, surgical treatment, and outcomes in spinal gout: a systematic review of 315 cases","volume":"32","author":"Harlianto","year":"2023","journal-title":"Eur Spine J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1590\/S0482-50042013000300008","article-title":"Gout in the spine","volume":"53","author":"Hasegawa","year":"2013","journal-title":"Rev Bras Reumatol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"E1531","DOI":"10.1097\/BRS.0000000000000633","article-title":"Axial gout is frequently associated with the presence of current tophi, although not with spinal symptoms","volume":"39","author":"de Mello","year":"2014","journal-title":"Spine"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.3899\/jrheum.111517","article-title":"Correlates of axial gout: a cross-sectional study","volume":"39","author":"Konatalapalli","year":"2012","journal-title":"J Rheumatol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3899\/jrheum.080374","article-title":"Gout in the axial skeleton","volume":"36","author":"Konatalapalli","year":"2009","journal-title":"J Rheumatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"339","DOI":"10.3389\/fmed.2020.00339","article-title":"The frequency of axial deposition in Korean patients with gout at a tertiary spine center","volume":"7","author":"Jin","year":"2020","journal-title":"Front Med (Lausanne)"},{"key":"B19","first-page":"871","article-title":"Pathologic changes in gout; survey of eleven necropsied cases","volume":"32","author":"Levin","year":"1956","journal-title":"Am J Pathol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.surneu.2006.03.038","article-title":"Spinal gout in a renal transplant patient: a case report and literature review","volume":"67","author":"Hou","year":"2007","journal-title":"Surg Neurol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1097\/MAJ.0b013e3181a3dc14","article-title":"Axial gouty arthropathy","volume":"338","author":"Saketkoo","year":"2009","journal-title":"Am J Med Sci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1136\/ard.9.4.282","article-title":"Gout; an unusual case with softening and subluxation of the first cervical vertebra and splenomegaly","volume":"9","author":"Kersley","year":"1950","journal-title":"Ann Rheum Dis"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1472886\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T06:48:58Z","timestamp":1739170138000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1472886\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,10]]},"references-count":22,"alternative-id":["10.3389\/fsurg.2025.1472886"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1472886","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2025,2,10]]},"article-number":"1472886"}}