1/2. Arthroscopic treatment for gouty tophi mimicking an intra-articular synovial tumor of the knee.Tophi deposition is a well-recognized complication of chronic gout, but usually lacks obvious symptoms. magnetic resonance imaging (MRI) findings may allow a relatively specific diagnosis to be rendered. In this study, we report an unusual case of gouty tophi presenting as an intra-articular synovial tumor of the knee, blocking the range of motion. We also describe its MRI appearance, which was compatible with the clinical suspicion. After arthroscopic excision of the "tumor," the patient was symptom free.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/2. gout, have we met before? No, not like this...learning OBJECTIVES: Extra-articular symptoms could be the first manifestation of gouty arthritis (GA); polyarticular GA can mimic an infectious arthritis; infection can complicate GA. CASE: A 66-year-old male with a history of gout presented with high fever and excruciating bilateral calf pain for 1 day. Examination revealed chronic knee effusions; range of motion in both knees was limited by calf pain. Joint aspiration showed negatively birefringent intracellular crystals and normal gram stain. HOSPITAL COURSE: While receiving empiric antibiotics fever continued and he developed bilateral knee, right ankle, and shoulder pain. After demonstration of urate crystals and exclusion of infection, antibiotics were discontinued and steroids initiated. fever, calf pain, and polyarthritis quickly resolved. DISCUSSION: Polyarticular gouty attack is an uncommon presentation of gout, and can mimic several other conditions. An exceptional presentation of this entity is excruciating calf pain, probably caused by tenosynovitis or referred pain preceding an acute polyarticular gouty attack.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |