1/5. Gouty tenosynovitis of the wrist.A 56-year-old man presented with a mass of the right wrist limiting excursion of the digits. Operative exploration demonstrated gouty infiltration of the flexor tendons. The tendons were debrided of the urate crystalline material and the motion of the digits returned, preserving all tendon function. The patient later returned with symptoms of carpal tunnel in the contralateral wrist. Exploration of the carpal tunnel revealed similar infiltration of the flexor tendons. The tendons were debrided and the carpal tunnel syndrome resolved.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/5. Limited knee joint range of motion due to invisible gouty tophi.OBJECTIVES: Tophi deposits are a well-known cause of joint destruction, gouty nephropathy and spinal cord compression. This study reports another major complication of gout, namely tophi deposition causing limited knee joint excursion. methods: Seven gout patients with limited knee joint excursion owing to tophi deposition were studied to reveal clinical features and magnetic resonance imaging (MRI) findings. None of the patients were able to assume a full squatting posture. RESULTS: No patients had visible subcutaneous tophi over the knee joints, except for one case in which a pea-sized subcutaneous tophus was noted. Additionally, two patients even lacked visible tophi elsewhere. All knee problems in the study group were initially regarded as being due to degenerative or other internal derangements, but MRI unexpectedly revealed multiple tophaceous depositions within and around the joint. CONCLUSIONS: Intra-articular and periarticular tophi limiting knee joint range of motion are a rare but important cause of walking disability in gout patients. Although most patients do not display visible subcutaneous tophi over the knee on physical examination, the differential diagnosis should consider intra-articular tophi and MRI is valuable in this clinical setting.- - - - - - - - - - ranking = 5keywords = motion (Clic here for more details about this article) |
3/5. Chronic tophaceous gout. A case report.A review of gout is presented, followed by a discussion of the current medical literature on diagnosis, differential diagnosis, staging, and treatment. Chronic tophaceous gout is not as prevalent as it once was because of early diagnosis and treatment, but it is still encountered in the podiatric practice. A severe case of chronic tophaceous gout is presented. The patient was successfully treated by surgical intervention. Although surgery may be avoided in most cases, it is indicated when intractable pain, loss of motion, and massive joint destruction are present.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/5. Gouty arthritis of the axial skeleton including the sacroiliac joints.We treated a 62-year-old man with intermittent polyarthritis whose neck pain was prominent. Progressive deformities, limited neck motion, and the appearance of subcutaneous nodules prompted his admission to the hospital. The diagnosis of gout was established; the erosive and destructive changes in C6-7 were believed to be due to gout as well. Cervical spine involvement, although rare, can occur in gout.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/5. Gouty tenosynovitis in the hand.Gouty tenosynovitis can present as an infection, tendon rupture, nerve compression, or digital stiffness. In ten patients, extensive urate deposition was encountered in the extensor tendons at both the wrist and digital levels in addition to involvement of the flexor tendons in the carpal canal and digital theca. Direct nerve or muscle involvement was not observed in the hand. Medical therapy, which is now the cornerstone of treatment for most aspects of gout, may not be the best treatment for tophaceous deposits in the hand. Operative treatment may be required to debulk tophaceous deposits, improve tendon gliding, decompress nerves, allow increased range of motion of joints, and ameliorate pain.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |