The necropsy of an 84-year-old woman with painful polyarticular gout showed a severe erosion of the L2 vertebral body due to sodium urate deposition. The radiological signs of this tophus had existed for many years; it had caused recurrent pain but no neurological complications. A small tophus and a Schmorl's node on 2 neighbouring thoracic vertebrae permitted the differentiation between vertebral plate erosion in the first, which was of bone origin, and vertebral plate remodelling in the second, which originated in the cartilaginous tissue of the disc.
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