{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T14:21:28Z","timestamp":1765808488581,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T00:00:00Z","timestamp":1754179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>In this report of two cases, we describe two patients with spinal involvement of gout. The first case involved a 67-year-old female who presented to the emergency department with a one-week history of weakness in both the upper and lower limbs, despite no prior history of gout. Cervical spine MRI revealed spinal cord compression at the C4 level from a posterior lesion. During surgery, chalky white deposits consistent with gouty tophi were observed in the ligamentum flavum within the epidural space at C4. These intraoperative findings correlated with elevated serum uric acid levels. The second case concerned a 68-year-old male who presented with a five-day history of right lower limb pain along with bilateral knee discomfort. Radiologic and laboratory evaluations revealed elevated inflammatory markers, negatively birefringent crystals in knee joint aspirate, spondylodiscitis at the L5-S1 level, and a right-sided synovial cyst at the T10\u2013T11 level causing spinal cord compression. Following the initiation of anti-gout therapy, the patient experienced significant clinical improvement, normalization of inflammatory markers, and radiologic resolution of the thoracic synovial cyst.<\/jats:p>","DOI":"10.3390\/reports8030135","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T09:41:17Z","timestamp":1754300477000},"page":"135","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spinal Gout: A Rare but Serious Mimicker of Spinal Pathology\u2014Report of Two Cases"],"prefix":"10.3390","volume":"8","author":[{"given":"Muhammad","family":"Ishfaq","sequence":"first","affiliation":[{"name":"Ng Teng Fong General Hospital, Singapore 609606, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeesh","family":"George","sequence":"additional","affiliation":[{"name":"Ng Teng Fong General Hospital, Singapore 609606, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan De","family":"Silva","sequence":"additional","affiliation":[{"name":"Ng Teng Fong General Hospital, Singapore 609606, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/BOR.0000000000000028","article-title":"Definition of hyperuricemia and gouty conditions","volume":"26","author":"Bardin","year":"2014","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.3899\/jrheum.080374","article-title":"Gout in the axial skeleton","volume":"36","author":"Konatalapalli","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1136\/annrheumdis-2019-215920","article-title":"Global, regional and national burden of rheumatoid arthritis 1990\u20132017: A systematic analysis of the Global Burden of Disease Study 2017","volume":"78","author":"Safiri","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s41043-025-00982-4","article-title":"Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: A systematic review","volume":"44","author":"Mustafa","year":"2025","journal-title":"J. Health Popul. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"052","DOI":"10.1055\/s-0034-1366979","article-title":"A Case of Tophaceous Gout in the Lumbar Spine: A Review of the Literature and Treatment Recommendations","volume":"5","author":"Calniquer","year":"2014","journal-title":"Evid. Based Spine-Care J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1302\/0301-620X.87B4.15555","article-title":"Crystal arthropathy of the lumbar spine","volume":"87","author":"Mahmud","year":"2005","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_7","doi-asserted-by":"crossref","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":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, J.X., Ng, B., Bak, H., Spencer, D., Manolios, N., and Wong, P.K. (2020). The utility of dual energy computed tomography in the management of axial gout: Case reports and literature review. BMC Rheumatol., 4.","DOI":"10.1186\/s41927-020-00119-6"},{"key":"ref_9","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":"ref_10","first-page":"e27101","article-title":"Spinal Cord Compression Due to Tophaceous Vertebral Gout: A Case Report","volume":"14","author":"Gutierrez","year":"2022","journal-title":"Cureus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s11926-012-0236-8","article-title":"Axial (Spinal) Gout","volume":"14","author":"Lumezanu","year":"2012","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.neuchi.2017.11.002","article-title":"Tophaceous gout causing thoracic spinal cord compression: Case report and review of the literature","volume":"64","author":"Ding","year":"2018","journal-title":"Neurochirurgie"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e15265","DOI":"10.1097\/MD.0000000000015265","article-title":"Diagnostic challenges of spinal gout: A case series","volume":"98","author":"Ma","year":"2019","journal-title":"Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S0140-6736(09)60883-7","article-title":"Gout","volume":"375","author":"Richette","year":"2010","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/BOR.0b013e3283361ac0","article-title":"Unusual clinical presentations of gout","volume":"22","author":"Ning","year":"2010","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_16","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":"ref_17","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":"ref_18","doi-asserted-by":"crossref","first-page":"106063","DOI":"10.1016\/j.ijscr.2021.106063","article-title":"Spinal gouty tophus presenting as an epidural mass lesion\u2014A case report","volume":"84","author":"Yip","year":"2021","journal-title":"Int. J. Surg. Case Rep."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/3\/135\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:22:12Z","timestamp":1760034132000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/8\/3\/135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,3]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["reports8030135"],"URL":"https:\/\/doi.org\/10.3390\/reports8030135","relation":{},"ISSN":["2571-841X"],"issn-type":[{"type":"electronic","value":"2571-841X"}],"subject":[],"published":{"date-parts":[[2025,8,3]]}}}