Spinal gout mimicking osteomyelitis

In this week’s MJA rheumatologists from Townsville Hospital in Queensland present the case of a 41-year-old man with a history of gout with severe thoracic back pain and fevers that caused him to be bed-bound for a week.

An MRI of the spine (below) revealed a lytic lesion on the T1 spinous process with inflammatory changes in the adjacent soft tissues and surrounded by a small collection of fluid. There was no spinal cord involvement.

The patient was treated for vertebral osteomyelitis and gout until a spinal aspirate showed monosodium urate crystals and made a full recovery.

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