J Korean Orthop Assoc.  2016 Apr;51(2):178-182. 10.4055/jkoa.2016.51.2.178.

Surgical Treatment of Gouty Tophi in Bilateral Popliteal Cysts

  • 1Department of Orthopaedic Surgery, Gwangju Bohun Hospital, Gwangju, Korea. girong@naver.com


Gout often occurs in the first metatarsophalyngeal joint, and also in the ankle joint and posterior foot. Knee joint gouty arthritis is commonly reported, but gouty tophi in bilateral popliteal cysts, such as this case, are rare. We report on a case treated by cystectomy of gouty tophi in bilateral popliteal cysts and review.


knee; gout; baker cyst; popliteal cyst; cystectomy

MeSH Terms

Ankle Joint
Arthritis, Gouty
Knee Joint
Popliteal Cyst*


  • Figure 1 (A) Gross finding on both popliteal areas. Approximately 70×60 mm sized firm and round masses are palpated on both popliteal areas. (B) Gross finding on the right 5th finger. Approximately 40×30 mm sized firm and whitish mass on the right 5th proximal interphalangeal joint.

  • Figure 2 (A) Preoperative lateral radiograph of the right knee. (B) Preoperative lateral radiograph of the left knee. Soft tissue masses are seen.

  • Figure 3 (A) Magnetic resonance imaging (MRI) of the right knee with T2-weighted fat suppression sagittal view shows diffuse calcified synovial thickening in the knee joint, with large calcified mass formation (approximately 6 cm in the long axis) in popliteal fossa. (B) MRI of the left knee T2-weighted. Sagittal view shows diffuse calcified synovial thickening in the knee joint, with large calcified mass formation (approximately 7.5 cm in the long axis) in popliteal fossa.

  • Figure 4 Tc-99m hydroxydiphosphonate (HDP) whole body bone scan showed a soft tissue mass with faint increased uptake behind both knee joints. Increased uptake is shown on both knee joints, left ankle joint, right elbow joint and other multiple joints.

  • Figure 5 (A) Operative findings. Gross findings of the mass left (B) and right (C). Whitish chalk and toothpaste-like materials were seen in both popliteal cysts.

  • Figure 6 Histological images of masses. Deposition of monosodium urate crystals (arrow) were seen (H&E, ×400).

Cited by  1 articles

Giant Tophi Involving Both Suprapatellar Pouches and Upper Poles of the Patellae: Treatment with Febuxostat and the 6 Years Follow-Up
Sung Tae Kim, Sang Yup Lee, Sang Jae Kim, Bum Soo Kim
J Korean Orthop Assoc. 2019;54(1):78-83.    doi: 10.4055/jkoa.2019.54.1.78.


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