Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement. (9th December 2014)

• Record Type: Journal Article
• Authors: Nunes, Eduardo Araújo Santana; Rosseti, Adroaldo Guimarães; Ribeiro, Daniel Sá; Santiago, Mittermayer
• Other Names: Cevik Remzi Academic Editor.
• Is Part Of: Case reports in rheumatology. Volume 2014(2014)
• Publication Date: 2014-12-09
• Subjects: Rheumatology -- Periodicals; Rheumatology -- Case studies -- Periodicals; Rheumatic Diseases; Connective Tissue Diseases; Rheumatology; Periodicals; Electronic journals; Case studies; Periodicals; 616.723
• DOI: 10.1155/2014/357826
• Languages: English
• ISSNs: 2090-6889

Abstract

Abstract : 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.