A rare manifestation of gout at the wrist--a case report

Schuind, Frédéric; Geertruyden, Jean Van; Stallenberg, Bernard; Remmelink, Myriam; Pasteels, Jean-Lambert

doi:10.1080/000164702321022910

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…The articular spaces are usually preserved for a long time, before destruction is caused by crystal deposition in the hyaline cartilage and synovial membrane, which lead to degeneration and ankylosis (11). In our patients there were no joint degeneration or ankylosis but limited range of motion that was resolved after surgery with physiotherapy, which was probably because of the mass that stretched the joint capsule.…”

Section: Discussionmentioning

confidence: 51%

“…The essential lesion of tophaceous gout is the deposition of crystals in cartilage, synovial membrane, periosteum, subchondral bone, bone marrow, tendons, ligaments, bursae, subcutaneous fat, and skin (8-10). In the upper extremity, tophi are usually located in the subcutaneous tissues, more commonly around the elbow and proximal interphalangeal joints (11).…”

Section: Discussionmentioning

confidence: 99%

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Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows

Kekeç¹,

Bozgeyik²,

Yılmaz³

2018

Eur J Ther

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Gout is a crystal deposition rheumatic disease. It is a more common inflammatory arthritis in men, characterized by formation of monosodium urate crystals in the synovial fluid of joints and in other tissues. It commonly deposits in the feet, ankles, knees, hands, wrists, and elbows. A 54-year-old male presented with big symmetrical masses developed gradually on both the elbows over the last 4 years. Radiographs of both the elbows showed soft tissue swellings with no involvement of bones. Masses were of intermediate signal intensity on T1-weighted magnetic resonance images and high signal intensity on T2-weighted images. Fine needle aspiration cytology was performed in masses on both the elbows. Light microscopy of the Giemsa-and Papanicolaou-stained smears demonstrated abundant granular amorphous material and scattered stacks of slender needle-shaped crystals, associated with chronic inflammatory infiltrate. Based on the above findings, a diagnosis of gout tophi was made. After informed consent with the patient under general anesthesia, marginal resection of tophi were performed in the same session with clear margins. We describe the treatment of a patient with long-standing chronic gout tophus located bilaterally at the elbow joint complicated by bursal deposit with rapid progression during the last 4 years. To the best of our knowledge, our case presentation may be the first case report where huge tophi were symmetrical and bilaterally presented on both the elbows.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows

Kekeç¹,

Bozgeyik²,

Yılmaz³

2018

Eur J Ther

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“…Dans d'autres cas similaires très rares, a été rapportée une lésion osseuse destructrice du semi-lunaire [7] et du capitatum [8], ou du semilunaire et du scaphoïde [3] dans la main tophacée. Ces lésions articulaires peuvent conduire à l'arthroplastie de remplacement, à l'arthrodèse [1], ou à la reconstruction des ligaments, tel que nous l'avons vu dans les deux cas cliniques.…”

Section: Discussionunclassified

“…Dans les cas très évolués peuvent se présenter des atteintes ostéoarticulaires, une infiltration et des ruptures tendineuses, une contracture digitale, des syndromes canalaires et une nécrose osseuse [1][2][3][4][5][6][7][8]. Le but de cette étude est de décrire deux cas cliniques inhabituels de dépôt tophacés de cristaux d'urate de sodium exceptionnellement volumineux, nombreux et atteignant quelques éléments anatomiques rarement intéressés au niveau de la main.…”

Section: Introductionunclassified

Rare manifestation de lésion ostéoarticulaire, tendineuse et neurologique par goutte tophacée de la main. Deux cas cliniques

Martínez-Villén

Canales

Hernández-Rossi

et al. 2007

Chirurgie de la Main

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“…Intraosseous appearance of gout presenting as lytic lesions is challenging in diagnostic management [62]. For demarcation of osteomyelitis or intraosseous tumors dual energy computed tomography and/or MRI is the method of choice [7,63,64].…”

Section: Clinical Presentation and Differential Diagnoses Of Goutmentioning

confidence: 99%

Gout – Practicable Interdisciplinary Insights for the Clinician on a Surgeon’s Perspective

Schmidt¹

2018

JRAD

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Gout is a common systemic metabolic disease caused either by increased uric acid production or by decreased uric acid excretion potentially leading to crystal deposition of monosodium urate in various tissues and resulting in acute gouty attacks mainly initially presenting as mono arthritis of joints. The further course can be accompanied with development of chronic tophaceous gout with or without complications such as skin perforation of tophi accompanied with occurrence of chronic fistula and overlying bacterial infection. When the diagnostic management was early and sufficiently done, it can be successfully treated by specific drugs in most cases, and approximately in up to 5% of cases only surgical intervention becomes necessary that includes various extremity-and motion-preserving procedures, but in life threatening conditions primary amputation as well. The aim of this article is to present practicable interdisciplinary insights of the disease for clinicians on a view of a surgeon.

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A rare manifestation of gout at the wrist--a case report

Cited by 8 publications

References 16 publications

Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows

Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows

Rare manifestation de lésion ostéoarticulaire, tendineuse et neurologique par goutte tophacée de la main. Deux cas cliniques

Gout – Practicable Interdisciplinary Insights for the Clinician on a Surgeon’s Perspective

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