Abstract
Rare sites for gout tophi A 58-year-old man with long-standing, untreated tophaceous gout developed serious dysphagia leading to the placement of a PEG probe. The symptoms were caused by laryngeal tophaceous gout. Further investigation by means of a dual-energy CT scan revealed extensive tophi with erosions of the cervical spine. Eventually, neurosurgery was necessary because of progressive, severe destruction of the dens axis. The prevalence of axial gout is likely to be higher than commonly thought and clinically recognized. All anatomical regions of the spine can be affected. Its clinical manifestations range from asymptomatic to neurological symptoms. A dual-energy CT scan is highly specific and sensitive for the diagnosis of gout. It is important to treat gout optimally to avoid serious complications.
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