J Korean Foot Ankle Soc.  2018 Sep;22(3):116-119. 10.14193/jkfas.2018.22.3.116.

Chronic Multiple Gouty Arthritis Diagnosed during Anti-Tuberculosis Treatment of Recurrent Tuberculous Arthritis: A Case Report

• Oh HC
• Choi YJ
• Ha JW
• Park SH
• Kim SH
• Yoon HK

• KMID: 2428669
• DOI: http://doi.org/10.14193/jkfas.2018.22.3.116

Abstract

Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.

Keyword

Gout; Polyarthritis; Antituberculosis

MeSH Terms

Arthritis*
Arthritis, Gouty*
Diagnosis
Elbow
Foot
Gout
Hallux
Hand
Humans
Pathology
Spine
Wrist

Figure

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  Figure 1. Bone scan shows hot uptake at right elbow, wrist, hand, foot, and lumbar area (black arrows). IV: intravenous.

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  Figure 2. (A) Gross photo shows swelling on right hallux. (B, C) Plain radiograph shows soft tissue swelling, bony erosion, osteopenia and mild subluxation on 1st metatarsal and phalanx.

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  Figure 3. Sagittal T1 (A) fat suppression and T2 (B) weighted magnetic resonance imaging demonstrates a low to intermediate signal intensity mass around 1st metatarsophalangeal joint.

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  Figure 4. Specimen shows chalky whitishy deposit.

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  Figure 5. Amorphous tophaceous deposit surrounded by multinucleated giant cells and macrophage was noted (H&E stain, ×100).

Reference

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