Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 24981
CERVICAL ARTHROPATHY CAUSED BY GOUT: A CASE REPORT AND
LITERATURE REVIEW ON THE MANAGEMENT
Dushan THAVARAJAH 1 , Rahim HUSSAIN 2 , John MARTIN 2
1 Milton Keynes General Hospital, Milton Keynes (UNITED KINGDOM), 2 Morriston
Hospital, Swansea (UNITED KINGDOM)
Study design: A retrospective case report. Objective: -Raise the issue of gout as a
potential cause of cervical pain and atlanto-axial subluxation -Raise the issue of the
treatment options available. -Illustrate this with a case and add this to a case series.
Summary of background data: The cervical spine is a rare site where tophaceous
gout has been identified. There are currently 15 described cases in the literature of
gouty involvement of the cervical spine with only three cases involving only the
atlanto-axial region. We add the fourth of such cases and only the second to be
managed operatively. Methods: History, focused neurological examination, magnetic
resonance, computed tomography scan images and transoral biopsy for our case.
Full literature review of pubmed, medline and embase for the remaining cases.
Results: It was decided that he would be a good candidate for a C0-C6 occipito -
cervical fusion which has been successful thus far. Conclusion: Atlanto-axial
subluxation should no longer be synonymous with only rheumatoid arthritis but also
tophaceous gout. Once suspicion is raised about atlanto-axial instability management
needs to come from temporary stabilisation (halo brace), definitive diagnosis
(transoral biopsy) and then definitive treatment (occipito-cervicalfusion).
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