Gout in Spial Vertebrae Mimicking Rheumatoid
Arthritis
Title: Tophaceous gout causing atlanto-axial
subluxation mimicking rheumatoid arthritis: A case report.
Authors: Wazir NN et al.
Publication: J Orthop Surg (Hong Kong). 2005
Aug;13(2):203-6.
The authors reported an extremely rare condition of gout found
at the joints between the vertebrae of the spine, causing a dislocation
at that joint that looks just like rheumatoid arthritis.
The authors highlighted a case of gouty arthritis (or also commonly
known as gout) at the joint between the C1 (atlas) and C2 (axis)
vertebrae of the spinal cord. This resulted in joint instability,
dislocation of the joint, and impairment of nerve function (Editor's
note: the exact problem is not disclosed, although it is most
likely caused by pinched nerves or neural impingement). A 66-year
old obese woman who had a joint disease, which affects multiple
of her joints, for the previous 3 years came with neck pain and
nerve function problems.
She was then treated with spinal decompression surgery and occipitocervical
(back of the skull and the neck) spinal fusion.
After the initial improvement after the treatment, however, the
patient developed complications, namely aspiration pneumonia or
inflammation of the lungs caused by inhalation of gastric contents,
and septicemia or blood poisoning caused by infection by microorganisms.
The authors concluded that since joint dislocation due to gout
can be very similar to that caused by rheumatoid arthritis, doctors
should keep this possibility in mind.
Editor’s note: in spinal decompression surgery, a
small portion of the bone over the nerve root or disc material under
the nerve is removed to relieve the pressure on the nerve and to
give it more space. It is often combined with a spine fusion surgery
to provide more stability to the joint where the bone has been removed.
