Intra-abdominal gout mimicking pelvic abscess

Abstract

Gout is the most common crystal-induced arthritis. Gouty tophi typically deposit in the extremities, especially toes and fingers. We present an unusual case of intrapelvic tophaceous gout in a patient suffering from chronic gouty arthritis. CT and MRI of the abdomen and pelvic cavity disclosed calcified gouty tophi around both hips, and a cystic lesion with peripheral enhancement in the pelvic cavity along the course of the iliopsoas muscle. The intra-abdominal tophus mimicked pelvic abscess.

Gout: An old disease in new perspective – A review

“…It is, however, useful for evaluation of gout at unusual sites. The literature abounds with case reports in the axial skeleton [94], [95], [96], [97], [98], [99], or presentation as spondyloarthritis [100], [101], carpal tunnel syndrome [102], [103], crown dens syndrome [104], paraspinal abscess [105], or intra-abdominal mass [106]. The diagnosis in these reports was made by MRI, which was occasionally combined with other modalities.…”

Chronic Tophaceous Gout of the Calf Mimicking Deep Venous Thrombosis

“…Recent case series reported that gouty tophi deposition developed at the very rare sites with atypical clinical manifestations, such as the hips (6), spine (7-9) and intra-abdominal gout mimicking pelvic abscess (10). To our knowledge, however, chronic tophaceous gout on the calf has not previously been reported in the English literature.…”

“…There were diffuse swelling and warmth of left calf with about 6 cm increase in calf circumference more Clinical risk factors for developing tophi at the unusual sites were not well known and may be drawn from a review of the cases reported until now. To consider the 3 cases of unusual tophi of spine and pelvic cavity, common characteristics were that all were males suffering from polyarticular gouty arthritis and poorly controlled gout with high level of serum uric acid (7)(8)(9)(10). In other report with spinal gout, the majority of patients (82%) had chronic polyarticular tophaceous gout and hyperuricemia, with a mean duration of disease of 14 years (range, 0 to 35 years) (8).…”

Die Gicht als Systemerkrankung

“…c Gichtperle an der Ohrhelix deutet wurden. Eine CT-gestützte Punktion erbrachte die Diagnose eines intrapelvinen Tophus [4].…”

“…Computertomographie (CT) und Magnetresonanztomographie (MRT) zeigten zystische Strukturen im Bereich des Psoasmuskel links, die zuerst als Abszess geAbb. 4 …”