Archives of Orthopaedic and Trauma Surgery

, Volume 115, Issue 5, pp 297–299 | Cite as

Unusual localisation of tophaceous gout

A report of four cases and review of the literature
  • P. Reber
  • X. Crevoisier
  • B. Noesberger
Current Problem Case


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.


Public Health Arthritis Clinical Symptom Medical History Gout 
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  1. 1.
    Benedek TG (1965) Lysis of the patella due to metastatic carcinoma. Arthritis Rheum 8:560–567Google Scholar
  2. 2.
    Burnham J, Fraker K, Steinbach H (1977) Pathologic fracture in an unusual case of gout. Am J Roentgenol 129:1116–1119Google Scholar
  3. 3.
    Greenberg DC (1986) Pathological fracture of the patella secondary to gout: a case report. J Bone Joint Surg [Am] 68:1286–1288Google Scholar
  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] 66:610–611Google Scholar
  5. 5.
    Kewenter Y (1936) Anatomical variations of the sesamoid bone of the toes. Acta Orthop Scand Suppl 2Google Scholar
  6. 6.
    Kransdorf MJ, Moser RP (1989) Primary tumors of the patella: a review of 42 cases. Skeletal Radiol 18:365–371Google Scholar
  7. 7.
    Leaney BJ, Calvert JM (1983) Tophaceous gout producing spinal cord compression: a case report. J Neurosurg 58:580–582Google Scholar
  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] 53:510–513Google Scholar
  9. 9.
    Linscheid RL, Dahlin DC (1966) Unusual lesions of the patella. J Bone Joint Surg [Am] 48:1359–1366Google Scholar
  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 40:416–418Google Scholar
  11. 11.
    Mercuri M, Casadei R, Ferraro A (1991) Tumors of the patella. Int Orthop 15:115–120Google Scholar
  12. 12.
    Miskew D (1980) Atraumatic avascular necrosis of the talus associated with hyperuricemia. Clin Orthop 148:156–159Google Scholar
  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] 69:1096–1099Google Scholar
  14. 14.
    Peloquin LU, Graham JH (1955) Gout of the patella: report of a case. N Engl J Med 253:979–980Google Scholar
  15. 15.
    Pledger SR, Hirsh B, Freiberg RA (1976) Bilateral carpal tunnel syndrome secondary to gouty tenosynovitis: a case report. Clin Orthop 118:188–189Google Scholar
  16. 16.
    Primm DD, Allen JR (1983) Gouty involvement of a flexor tendon in the hand. J Hand Surg 8:836–865Google Scholar
  17. 17.
    Stoler B, Staple TW (1965) Metastases to the patella. Radiology 93:853–856Google Scholar
  18. 18.
    Torke M, Henderson C (1990) Tophaceous gout simulating infection about a stainless steel plate. J Orthop Trauma 4:463–465Google Scholar
  19. 19.
    Wald SL, McLennan JE, Carroll RM, Segal H (1979) Extradural spinal involvement by gout: a case report. J Neurosurg 50:236–239Google Scholar
  20. 20.
    Wyngaarden JB, Kelly WN (1986) Gout and hyperuricemia. Grune and Stratton, New YorkGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • P. Reber
    • 1
  • X. Crevoisier
    • 1
  • B. Noesberger
    • 1
  1. 1.Department of Traumatology and Orthopedic SurgeryRegionalspitalInterlakenSwitzerland

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