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Chronic tophaceous gout presenting as acute arthritis during an acute illness: a case report.

Dhoble A, Balakrishnan V, Smith R - Cases J (2008)

Bottom Line: The acute episode was successfully treated with colchicines and indomethacin.Gout usually flares up during an acute illness, and should be considered while evaluating acute mono articular arthritis.Rarely, it can also present with tophi as an initial manifestation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Michigan State University, East Lansing, Michigan, USA. abhijeetdhoble@gmail.com.

ABSTRACT

Background: Gout is a metabolic disease that can manifest as acute or chronic arthritis, and deposition of urate crystals in connective tissue and kidneys. It can either manifest as acute arthritis or chronic tophaceous gout.

Case presentation: We present a 39-year-old male patient who developed acute arthritis during his hospital course. Later on, after a careful physical examination, patient was found to have chronic tophaceous gout. The acute episode was successfully treated with colchicines and indomethacin.

Conclusion: Gout usually flares up during an acute illness, and should be considered while evaluating acute mono articular arthritis. Rarely, it can also present with tophi as an initial manifestation.

No MeSH data available.


Related in: MedlinePlus

Tophi/tophus around the proximal inter-phalangeal joint of right middle finger.
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Figure 2: Tophi/tophus around the proximal inter-phalangeal joint of right middle finger.

Mentions: On the third day of hospitalization, he developed acute, severe pain and swelling of the left elbow. Within next few hours, pain worsened and he was unable to move the elbow joint, which was tender, erythematous, and swollen on examination (figure 1). Never investigated in the past, we also noted a firm 4 × 6 cm mass on each elbow, and another one surrounding the proximal inter-phalangeal joint of right middle finger (figure 2). There was no overlying edema or cellulitis. There were no other swellings or tophi noted especially on toes or ears. When asked particularly, he denied similar episodes in the past. He also denied any episode of swelling of great toe in the past.


Chronic tophaceous gout presenting as acute arthritis during an acute illness: a case report.

Dhoble A, Balakrishnan V, Smith R - Cases J (2008)

Tophi/tophus around the proximal inter-phalangeal joint of right middle finger.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2572609&req=5

Figure 2: Tophi/tophus around the proximal inter-phalangeal joint of right middle finger.
Mentions: On the third day of hospitalization, he developed acute, severe pain and swelling of the left elbow. Within next few hours, pain worsened and he was unable to move the elbow joint, which was tender, erythematous, and swollen on examination (figure 1). Never investigated in the past, we also noted a firm 4 × 6 cm mass on each elbow, and another one surrounding the proximal inter-phalangeal joint of right middle finger (figure 2). There was no overlying edema or cellulitis. There were no other swellings or tophi noted especially on toes or ears. When asked particularly, he denied similar episodes in the past. He also denied any episode of swelling of great toe in the past.

Bottom Line: The acute episode was successfully treated with colchicines and indomethacin.Gout usually flares up during an acute illness, and should be considered while evaluating acute mono articular arthritis.Rarely, it can also present with tophi as an initial manifestation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Michigan State University, East Lansing, Michigan, USA. abhijeetdhoble@gmail.com.

ABSTRACT

Background: Gout is a metabolic disease that can manifest as acute or chronic arthritis, and deposition of urate crystals in connective tissue and kidneys. It can either manifest as acute arthritis or chronic tophaceous gout.

Case presentation: We present a 39-year-old male patient who developed acute arthritis during his hospital course. Later on, after a careful physical examination, patient was found to have chronic tophaceous gout. The acute episode was successfully treated with colchicines and indomethacin.

Conclusion: Gout usually flares up during an acute illness, and should be considered while evaluating acute mono articular arthritis. Rarely, it can also present with tophi as an initial manifestation.

No MeSH data available.


Related in: MedlinePlus