Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 10, Number 11, November 2019, pages 333-337

Multilevel Lumbar Stenosis Caused by Large Tophi Involving Both Spinal Canal and Posterior Spinal Elements: A Rare Case Report and Literature Review

Figures

Figure 1.
Figure 1. Clinical photos show tophi erosions throughout the patient’s four limbs. (a, b, c, d) Upper limbs; (e) Bilateral feet.
Figure 2.
Figure 2. The X-ray films show the bony erosion and vague borderline of the tophi. (a) Anteroposterior (AP) view, facets erosion (arrow heads); (b) Lateral view. Vague borderline of the tophi can be observed.
Figure 3.
Figure 3. The magnetic resonance imaging (MRI) shows the severity of neurologic compression. (a) Mid-sagittal view, spinal stenosis at L2 and L4; (b) Axial view at upper L3 level. Severe spinal stenosis can be observed.
Figure 4.
Figure 4. The dual-energy computed tomography shows the dimensions and volume of the tophi. (a) Para-sagittal view; (b) Axial view; (c) Lateral view; (d) Posterior view.
Figure 5.
Figure 5. The pathological manifestations under microscope with hematoxylin and eosin (H&E) staining. (a) Urate crystals can be observed (blue); (b) Inflammatory cell infiltration in the soft tissues invaded by the tophi.