Recurrent back pain and fevers

An elderly woman presented with her third episode of back pain, fever and neurological deficits. She subsequently developed pseudogout of the knee, and a diagnosis was made of systemic calcium pyrophosphate deposition disease (CPPD) involving the spine and causing intermittent cauda equina syndrome. This case illustrates the difficulty of differentiating infection from CPPD.

In December 2005, a 78-year-old woman presented to the emergency department with acute onset of severe lumbar back pain radiating down both posterior thighs, bilateral leg weakness, and paraesthesiae of the feet on getting out of bed that morning.