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Unusual localisation of tophaceous gout

A report of four cases and review of the literature

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We report four cases with very unusual manifestations of tophaceous gout. All patients were male, aged between 29 and 67 years. Only one patient had an acute gouty arthritis in his medical history, whereas the other three had never developed clinical symptoms from their hyperuricemia. Two patients had gout tophi in the patella, while the others showed gout tophi in the space of bipartite bones, one in a bipartite patella and one in a tripartite sesamoid bone of the first toe. To our knowledge, gout tophi in the space of bi- or tripartite bones has never been described before.

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  1. 1.

    Benedek TG (1965) Lysis of the patella due to metastatic carcinoma. Arthritis Rheum 8:560–567

  2. 2.

    Burnham J, Fraker K, Steinbach H (1977) Pathologic fracture in an unusual case of gout. Am J Roentgenol 129:1116–1119

  3. 3.

    Greenberg DC (1986) Pathological fracture of the patella secondary to gout: a case report. J Bone Joint Surg [Am] 68:1286–1288

  4. 4.

    Healy JG, Dines D, Hershon S (1984) Painful synovitis secondary to gout in the area of prosthetic hip joint: a case report. J Bone Joint Surg [Am] 66:610–611

  5. 5.

    Kewenter Y (1936) Anatomical variations of the sesamoid bone of the toes. Acta Orthop Scand Suppl 2

  6. 6.

    Kransdorf MJ, Moser RP (1989) Primary tumors of the patella: a review of 42 cases. Skeletal Radiol 18:365–371

  7. 7.

    Leaney BJ, Calvert JM (1983) Tophaceous gout producing spinal cord compression: a case report. J Neurosurg 58:580–582

  8. 8.

    Levy M, Seelenfreund M, Maor P, Fried A (1971) Bilateral spontaneous and simultaneous rupture of the quadriceps tendon in gout. J Bone Joint Surg [Br] 53:510–513

  9. 9.

    Linscheid RL, Dahlin DC (1966) Unusual lesions of the patella. J Bone Joint Surg [Am] 48:1359–1366

  10. 10.

    Mahoney P, James PD, Howell CJ, Swannell AJ (1981) Spontaneous rupture of the Achilles tendon in a patient with gout: a case report. Ann Rheum Dis 40:416–418

  11. 11.

    Mercuri M, Casadei R, Ferraro A (1991) Tumors of the patella. Int Orthop 15:115–120

  12. 12.

    Miskew D (1980) Atraumatic avascular necrosis of the talus associated with hyperuricemia. Clin Orthop 148:156–159

  13. 13.

    Ortman BL, Pack LL (1987) Aseptic loosening of a total hip prosthesis secondary to tophaceous gout: a case report. J Bone Joint Surg [Am] 69:1096–1099

  14. 14.

    Peloquin LU, Graham JH (1955) Gout of the patella: report of a case. N Engl J Med 253:979–980

  15. 15.

    Pledger SR, Hirsh B, Freiberg RA (1976) Bilateral carpal tunnel syndrome secondary to gouty tenosynovitis: a case report. Clin Orthop 118:188–189

  16. 16.

    Primm DD, Allen JR (1983) Gouty involvement of a flexor tendon in the hand. J Hand Surg 8:836–865

  17. 17.

    Stoler B, Staple TW (1965) Metastases to the patella. Radiology 93:853–856

  18. 18.

    Torke M, Henderson C (1990) Tophaceous gout simulating infection about a stainless steel plate. J Orthop Trauma 4:463–465

  19. 19.

    Wald SL, McLennan JE, Carroll RM, Segal H (1979) Extradural spinal involvement by gout: a case report. J Neurosurg 50:236–239

  20. 20.

    Wyngaarden JB, Kelly WN (1986) Gout and hyperuricemia. Grune and Stratton, New York

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Reber, P., Crevoisier, X. & Noesberger, B. Unusual localisation of tophaceous gout. Arch Orthop Trauma Surg 115, 297–299 (1996).

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  • Public Health
  • Arthritis
  • Clinical Symptom
  • Medical History
  • Gout