J Korean Orthop Assoc.  2008 Feb;43(1):139-142. 10.4055/jkoa.2008.43.1.139.

Gout Tophi in the Bipartite Patella: A Case Report

• Kim MK
• Moon KH
• Lee TJ
• Kim L
• Lee JS

• KMID: 2106431
• DOI: http://doi.org/10.4055/jkoa.2008.43.1.139

Abstract

Osteolysis of the patella occurs in benign or malignant bone tumors, metastatic disease, osteolytic infections, degenerative, or metabolic bone disease. Several cases of patellar destruction secondary to gout have been reported. However, there has only been one case of bipartite patellar bone destruction secondary to gout reported in the literature. We encountered a patient with an osteolytic lesion of the bipartite patella suggesting a bone tumor or metabolic bone disease. A biopsy and histology examination suggested a diagnosis of gout tophi. This case demonstrated bilateral bipartite patella with gout involvement on the plain roentgenograms.

Keyword

Bipartite patella; Gout

MeSH Terms

Biopsy
Bone Diseases, Metabolic
Gout
Humans
Patella

Figure

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  Fig. 1 Plain radiographs of the knee. (A, B) Both knee AP and lateral view showing an osteolytic lesion with cortical breakage on the superolateral portion of thepatella. (C) Both knee skyline view showing an osteolytic lesion on the lateral portion of the patella.

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  Fig. 2 Sagittal images of the knee MRI. (A) Sagittal T1-weighted MRI of the knee demonstrating a multilobulated intermediate signal intensity mass in the superolateral aspect of the patella. (B) Sagittal T2-weighted image showing heterogeneous high signal intensity.

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  Fig. 3 Photomicrograph shows amorphous deposits of needle-shaped crystals (arrow) associated with mononuclear and giant cell inflammation (curved arrow) (H&E stain, ×200).

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  Fig. 4 There are needle-shaped crystals (arrow) on polarized optical microscopy.

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