Sterile spondylodiscitis

In reports of gouty arthritis involving the spine, most patients were male, had a history of gout, presented with neurological deficits and localised pain, and had high concentrations of urate and inflammatory markers in the serum.1-3 The latter finding is probably a result of the release of interleukins by monocytes and synoviocytes reacting to crystals. Spinal gout is predominantly located in the lumbar region.3,4 Radiological findings include vertebral erosions predominantly at the discovertebral junction and epidural space.4 On MRI, these erosions are commonly isointense or hypointense and show homogeneous contrast enhancement.2,3 Several risk factors have been proposed to trigger, or to be associated with, acute attacks of gouty arthritis.5 High urate concentrations in conjunction with previous degenerative change may have predisposed our patient to gouty inflammation.