Spinal meningioma differential diagnosis
The primary differential are neurogenic tumors (spinal schwannoma & spinal neurofibroma):
Typically located anteriorly (compared to spinal meningiomas that are usually located posterolaterally)
Tendency for multiplicity
May have low-intensity central regions on post-contrast T1 and T2 weighted images
Not associated with a broad dural base
Neural exit foraminal widening is more commonly seen with nerve sheath tumours.
Although spinal gout is rare, it should be considered in the differential diagnosis for patients presenting with symptoms of spinal stenosis, a suspicion of neoplastic lesion of the spine, and a previous history of gout. Early diagnosis can ensure proper and timely medical management, perhaps avoiding neurological compromise and the need for surgery 1).
Expert's comment concerning Grand Rounds case entitled “Tophaceous gout of the lumbar spine mimicking a spinal meningioma” by Pedro Ribeiro da Cunha Ferreira, António Judice Peliz, and Marcos Barbosa (Eur Spine J, 2016; DOI 10.1007/s00586-016-4831-7) 2).
Primary Spinal Lymphoma Masquerading as Meningioma: Pre-and post-operative Magnetic Resonance Imaging Findings 3).