Abstract
Ankylosing spondylitis (AS) rarely coexists with tophaceous gout in the spine. We present a case of a 57-year-old businessman with AS who did not have previous history of hyperuricemia or gouty arthritis. He had a three-month history of progressive bilateral lower limb weakness caused by spinal cord compression (rooted on a tophaceous gout), leading to incomplete paraplegia. He received surgical decompressive laminectomy, which removed the hypertrophic ligamentum flavum and tophus in the level of thoracolumbar junction. There was no obvious neurologic recovery after the surgery. We reviewed the incidence, clinical manifestations, and management of the spinal tophaceous gout coexisting with AS. Non-steroidal anti-inflammatory drugs are used widely for symptom control in patients with AS; this may lead to an under-diagnosis of gout because its clinical signs can be masked by the NSAID drugs. Spinal tophaceous gout should then be considered for patients with a history of rheumatic disorder and myeolopathy.
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