中山醫學大學機構典藏 CSMUIR:Item 310902500/3624
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    题名: Surgical versus Pharmacologic Treatment of Intraspinal Gout
    作者: Chang, I-Chang
    贡献者: 中山醫學大學：醫學系
    日期: 2005
    上传时间: 2011-03-16T02:28:22Z (UTC)
    摘要: A controversy between pharmacologic and surgical treatment of intraspinal gout exists in the literature. If gout is diagnosed timely, pharmacologic therapy may avert the need of surgery. The lack of readily available synovial fluid makes the diagnosis particularly difficult. The purpose of this study was to evaluate the clinical pictures and magnetic resonance imaging features in rapid differentiations of intraspinal gout. I retrospectively evaluated lumbar intraspinal tophaceous gout without the classic radiographic punched-out lesions. Four patients (average age, 65 years) had a history of hyperuricemia with multiple tophaceous deposits in the joints or visceral organs or both. The common presentations were low back pain with or without inflammatory reaction (fever, elevated C-reactive protein level, and mild leukocytosis). The patients also presented with intermittent claudication or radiculopathy of variable duration or both. The gouty tophi yielded homogeneous and hypointense masses on T1- and T2-weighted images, with multiple hypointense speckles. The masses were located in bilateral lumbar facet joints in all patients, with additional midline extension along the ligamentum flavum in three. All patients had uneventful outcomes after surgical decompression and pharmacologic treatment. Rapid deposition of tophi may aggravate nerve compression. If neurologic deficits are found, surgical decompression can provide a satisfactory outcome.
    Level of Evidence: Therapeutic study, Level IV. See the Guidelines for Authors for a complete description of levels of evidence.
    URI: https://ir.csmu.edu.tw:8080/handle/310902500/3624
    關聯: Clinical Orthopaedics and Related Research,Issue: Volume 433, April 2005, pp 106-110
    显示于类别:[醫學系] 期刊論文

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