Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement

Autor: Eduardo Araújo Santana Nunes, Adroaldo Guimarães Rosseti, Daniel Sá Ribeiro, Mittermayer Santiago
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Case Reports in Rheumatology, Vol 2014 (2014)
Druh dokumentu: article
ISSN: 2090-6889
2090-6897
DOI: 10.1155/2014/357826
Popis: Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA). We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications.
Databáze: Directory of Open Access Journals