J Rheum Dis.  2012 Jun;19(3):156-159. 10.4078/jrd.2012.19.3.156.

Chronic Tophaceous Gout of the Calf Mimicking Deep Venous Thrombosis

• Cho IJ
• Yoo WH

• KMID: 2223098
• DOI: http://doi.org/10.4078/jrd.2012.19.3.156

Abstract

Gout is a metabolic disease characterized by hyperuricemia, recurrent attacks of acute arthritis and deposits of monosodium urate monohydrate (tophi). Gouty tophi typically deposit in the peripheral regions of the body, especially in toes and fingers. However, it can form at unusual sites and present with atypical clinical features. We here report a very rare case of patient with chronic gout who developed tophi on the calf and mimicking thrombophlebitis. She was successfully treated with drainage, colchicine and hypouricemic agents. We suggest that large tophi on the calf can be a very rare clinical feature of chronic gout and need careful attention for exact diagnosis and proper treatment.

Keyword

Gout; Tophi; Thrombophlebitis

MeSH Terms

Arthritis
Colchicine
Drainage
Fingers
Gout
Humans
Hyperuricemia
Metabolic Diseases
Thrombophlebitis
Toes
Uric Acid
Venous Thrombosis
Colchicine
Uric Acid

Figure

• 

  Figure 1 Ultrasonography of the left calf shows diffuse, high density on the subcutaneous layer, and a hypo-echogenic lesion between the gastrocnemius muscle and subcutaneous deep fascia (arrow).

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  Figure 2 T1-weighted MR images of the left calf area show a well-circumscribed, cystic lesion with low signal intensity (arrows), between the gastrocnemius muscle and the deep fascia of calf, in sagittal (A) and coronal views (B).

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  Figure 3 T2-weighted MR images of the left calf area show a well-circumscribed, cystic lesion with high signal intensity (arrows), between the gastrocnemius muscle and the deep fascia of the calf, in sagittal (A) and coronal views (B).

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