Tophaceous Gout of Lumbar Spine with Fever Mimicking Infection

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Presentation transcript:

Tophaceous Gout of Lumbar Spine with Fever Mimicking Infection De-an Qin, MD, Jie-fu Song, MD, Xiao-fang Li, MD, Yan-yan Dong, MD The American Journal of Medicine Volume 131, Issue 9, Pages e353-e356 (September 2018) DOI: 10.1016/j.amjmed.2018.04.021 Copyright © 2018 Terms and Conditions

Figure 1 (A) Computed tomography showing an ill-defined and erosive lesion in the L4 facet joint. (B) Magnetic resonance imaging T1-weighted images showing disseminated and extensive hypointense foci on L3-5 facet joints and pedicles. (C) Magnetic resonance imaging T2 fat saturation image showing numerous hyperintense and oval masses within sacrospinal muscle. (D) Homogeneous peripheral enhancement after the intravenous administration of gadolinium for the masses. (E) Plain radiograph of tophaceous enthesopathy of the left foot. (F) Plain radiograph of tophaceous enthesopathy of the bilateral anterior inferior iliac spine, greater trochanter, and lesser trochanter. (The arrows denote the lesions.) The American Journal of Medicine 2018 131, e353-e356DOI: (10.1016/j.amjmed.2018.04.021) Copyright © 2018 Terms and Conditions

Figure 2 Computed tomography–guided core needle biopsy of the lumbar erosive facet for histologic diagnosis (arrow). The American Journal of Medicine 2018 131, e353-e356DOI: (10.1016/j.amjmed.2018.04.021) Copyright © 2018 Terms and Conditions

Figure 3 Mononuclear cells, multinuclear giant cells, and patchy fibrosis exudation including homogenous, pink eosinophilic and ill-defined material (HE, 10*). The American Journal of Medicine 2018 131, e353-e356DOI: (10.1016/j.amjmed.2018.04.021) Copyright © 2018 Terms and Conditions