Cervical gouty myelopathy in two cases at King Abdulaziz Medical City

Gout is a rheumatological disorder found exclusively in human species. It is caused by deposition of crystals of monosodium urate in joints, cartilages, tendons, and soft tissues. Involvement of the spine, however, is rare. In this report, we describe two patients presented to King Abdulaziz Medical City in Jeddah with clinical features of cervical myelopathy, including neck pain, L'hermitte phenomena, quadriparesis and sensory deficit (shoulder level). Magnetic resonance imaging confirmed the presence of cervical cord compression with intrinsic cord signal abnormalities. Both patients had laminectomy and intraoperatively; severe canal stenosis was identified. A whitish cheesy material was noticed causing significant root compression. The pathology was diagnostic of gout. In this article, we present two difficult cases with interesting clinical, radiological and pathological findings. We emphasize on the importance of early diagnosis to prevent morbidity.