Pseudogout of the cervical and thoracic spine mimicking infection after lumbar fusion: case report

Journal of Neurosurgery. Spine
Kelly J BridgesKhoi D Than

Abstract

Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess. Serial blood cultures and repeat biopsy samples were sterile. Subsequent wrist and ankle erythema, pain, and swelling led to synovial fluid analysis, and pseudogout was diagnosed. She was treated with an interleukin-1 inhibitor with immediate symptom relief. To the authors' knowledge, this is only the second report of spinal pseudogout presenting with a clinical and radiographic picture consistent with discitis and epidural abscess. This report is the first to report skip lesions of pseudogout occurring throughout the spine that are uniquely remote from a recent lumbar surgery.

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Citations

Apr 19, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Giorgos LoizidisJoshua Fitzgerald Baker
Aug 18, 2020·Case Reports in Orthopedics·Hironari KaneyamaTakeshi Maeda
Feb 26, 2020·Case Reports in Rheumatology·Indrit GrecaDan Zaccarini

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Methods Mentioned

BETA
biopsy
biopsies
light microscopy

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