Yıl: 2018 Cilt: 24 Sayı: 3 Sayfa Aralığı: 189 - 191 Metin Dili: İngilizce DOI: 10.5152/EurJTher.2018.312 İndeks Tarihi: 16-10-2019

Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows

Öz:
Gout is a crystal deposition rheumatic disease. It is a more common inflammatory arthritis in men, characterized by formation ofmonosodium urate crystals in the synovial fluid of joints and in other tissues. It commonly deposits in the feet, ankles, knees, hands,wrists, and elbows. A 54-year-old male presented with big symmetrical masses developed gradually on both the elbows over thelast 4 years. Radiographs of both the elbows showed soft tissue swellings with no involvement of bones. Masses were of intermediatesignal intensity on T1-weighted magnetic resonance images and high signal intensity on T2-weighted images. Fine needleaspiration cytology was performed in masses on both the elbows. Light microscopy of the Giemsa- and Papanicolaou-stainedsmears demonstrated abundant granular amorphous material and scattered stacks of slender needle-shaped crystals, associatedwith chronic inflammatory infiltrate. Based on the above findings, a diagnosis of gout tophi was made. After informed consentwith the patient under general anesthesia, marginal resection of tophi were performed in the same session with clear margins. Wedescribe the treatment of a patient with long-standing chronic gout tophus located bilaterally at the elbow joint complicated bybursal deposit with rapid progression during the last 4 years. To the best of our knowledge, our case presentation may be the firstcase report where huge tophi were symmetrical and bilaterally presented on both the elbows.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp
Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
  • Smith EU, Díaz-Torné C, Perez-Ruiz F, March LM. Epidemiology of gout: an update. Best Pract Res Clin Rheumatol 2010; 24: 811-27.
  • Koley S, Salodkar A, Choudhary SA, Singhania K, Choudhury M. Tophi as first manifestation of gout. Indian J Dermatol Venereol Leprol 2010; 76: 393-6.
  • Falasca GF. Metabolic diseases: gout. Clin Dermatol 2006; 24: 498- 508.
  • Grahame R, Scott J T. Clinical survey of 354 patients with gout. Ann Rheum Dis 1970; 29: 461-8.
  • Nishioka N, Mikanagi K. Clinical features of 4000 gouty subjects in Japan. Adv Exp Med Biol 1980; 122: 47-54.
  • Kelley WN, Schumacher HR. Crystal-associated synovitis-gout. In: Kelly WN, Harris ED, Ruddy S (eds). Textbook of Rheumatology, vol 2, 4th edn. Saunders, Philadelphia, 1993; 1291-336.
  • Hasturk AE, Basmaci M, Canbay S, Vural C, Erten F. Spinal gout tophus: a very rare cause of radiculopathy. Eur Spine J 2012; 21: 400- 3.
  • Nishioka N, Mikanagi K. Clinical Features of 4,000 Gouty Subjects in Japan. Adv Exp Med Biol 1980; 122: 47-54.
  • Nakayama DA, Barthelemy C, Carrera G, Lightfoot RW, Wortmann RL. Tophaceous Gout: A Clinical and Radiographic Assessment. Arthritis Rheum 1984; 27: 468-71.
  • Resnick D, Niwayama G. Gouty arthritis. Resnick D, editor. Diagnosis of bone and joint disorders. 3rd ed. Philadelphia: W.B. Saunders Company, 1995; 1511-55.
  • Schuind FA, Van Geertruyden J, Stallenberg B, Remmelink M, Pasteels JL. A rare manifestation of gout at the wrist--a case report. Acta Orthop Scand 2002; 73: 594-6.
  • Dhanda S, Jagmohan P, Quek ST. Tian, A re-look at an old disease: A multimodality review on gout. Clin Radiol 2011; 66: 984-92.
  • Carnero S, Terán P, Trillo E. Malignant fibrous histiocytoma arising in a gouty tophus at the second metacarpophalangeal joint. J Plast Reconstr Aesthet Surg 2006: 59: 775-8.
  • Dalbeth N, Doyle AJ. Imaging of gout: An overview. Best Pract Res Clin Rheumatol 2012; 26: 823-38.
APA KEKEÇ A, Bozgeyik B, yılmaz s (2018). Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. , 189 - 191. 10.5152/EurJTher.2018.312
Chicago KEKEÇ AHMET FEVZİ,Bozgeyik Bilgin,yılmaz selçuk Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. (2018): 189 - 191. 10.5152/EurJTher.2018.312
MLA KEKEÇ AHMET FEVZİ,Bozgeyik Bilgin,yılmaz selçuk Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. , 2018, ss.189 - 191. 10.5152/EurJTher.2018.312
AMA KEKEÇ A,Bozgeyik B,yılmaz s Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. . 2018; 189 - 191. 10.5152/EurJTher.2018.312
Vancouver KEKEÇ A,Bozgeyik B,yılmaz s Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. . 2018; 189 - 191. 10.5152/EurJTher.2018.312
IEEE KEKEÇ A,Bozgeyik B,yılmaz s "Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows." , ss.189 - 191, 2018. 10.5152/EurJTher.2018.312
ISNAD KEKEÇ, AHMET FEVZİ vd. "Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows". (2018), 189-191. https://doi.org/10.5152/EurJTher.2018.312
APA KEKEÇ A, Bozgeyik B, yılmaz s (2018). Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. European Journal of Therapeutics, 24(3), 189 - 191. 10.5152/EurJTher.2018.312
Chicago KEKEÇ AHMET FEVZİ,Bozgeyik Bilgin,yılmaz selçuk Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. European Journal of Therapeutics 24, no.3 (2018): 189 - 191. 10.5152/EurJTher.2018.312
MLA KEKEÇ AHMET FEVZİ,Bozgeyik Bilgin,yılmaz selçuk Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. European Journal of Therapeutics, vol.24, no.3, 2018, ss.189 - 191. 10.5152/EurJTher.2018.312
AMA KEKEÇ A,Bozgeyik B,yılmaz s Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. European Journal of Therapeutics. 2018; 24(3): 189 - 191. 10.5152/EurJTher.2018.312
Vancouver KEKEÇ A,Bozgeyik B,yılmaz s Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows. European Journal of Therapeutics. 2018; 24(3): 189 - 191. 10.5152/EurJTher.2018.312
IEEE KEKEÇ A,Bozgeyik B,yılmaz s "Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows." European Journal of Therapeutics, 24, ss.189 - 191, 2018. 10.5152/EurJTher.2018.312
ISNAD KEKEÇ, AHMET FEVZİ vd. "Unusual Presentation of Bilaterally Symmetrical Gout Tophi on Elbows". European Journal of Therapeutics 24/3 (2018), 189-191. https://doi.org/10.5152/EurJTher.2018.312