1/55. Chronic tophaceous gouty arthritis mimicking rheumatoid arthritis.OBJECTIVES: To analyze the factors which differentiate chronic tophaceous arthritis from rheumatoid arthritis. methods: We describe two cases of chronic gouty arthritis masquerading as rheumatoid arthritis. The characteristic features of each of these two conditions and the diagnostic approach are discussed in light of relevant literature. RESULTS: The correct diagnosis was reached by the combination of accurate history taking (family history of gout, alcoholism, previous diuretic therapy and renal stones), guiding clinical features (subcutaneous tophaceous deposits) and specific radiological (assymetrical erosions with sclerotic margins and overlying edges) and laboratory findings (hyperuricemia and hyperuricosuria). It was confirmed by the identification of monosodium urate (MSU) crystals in the synovial and subcutaneous tissues. CONCLUSIONS: gout and rheumatoid arthritis rarely coexist. Chronic gouty arthritis may mimic rheumatoid arthritis, and vice-versa. Clinical suspicion supplemented by characteristic laboratory, radiological and histologic findings help at reaching an accurate diagnosis.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/55. Gouty arthritis in a female patient with mixed connective tissue disease.gout with systemic lupus erythematosus (SLE) or progressive systemic sclerosis (PSS) has rarely been reported, whereas mixed connective tissue disease (MCTD) with the demonstration of intra-articular monosodium urate crystals has never been reported. We describe an unusual case of MCTD (SLE-PSS) in a 37-year-old woman who developed acute gouty arthritis. Arthrocentesis and synovianalysis may be necessary to differentiate gout from the arthropathy of MCTD.- - - - - - - - - - ranking = 0.33333333333333keywords = arthritis (Clic here for more details about this article) |
3/55. Scapholunate dissociation caused by gouty arthritis of the wrist. Case report.Gouty arthritis of the wrist is rare, and may be associated with scapholunate dissociation. To our knowledge, only two cases have been reported so far. In this report, we describe a 40-year-old patient with scapholunate dissociation caused by acute gouty arthritis of the wrist. His clinical findings and radiographs mimicked infectious arthritis or osteomyelitis of the carpal bones.- - - - - - - - - - ranking = 0.46666666666667keywords = arthritis (Clic here for more details about this article) |
4/55. Surgical management of tophaceous gout in the hand.A patient who suffered from severe deforming arthritis secondary to chronic tophaceous gout with multilobular, solid, tender, enlarged subcutaneous nodules and draining tophi in both hands was evaluated and treated by second ray amputation of the most deformed second finger to provide a more functional result.- - - - - - - - - - ranking = 0.066666666666667keywords = arthritis (Clic here for more details about this article) |
5/55. Pseudomelanosis duodeni: association with hypertension and chronic renal failure: case report.We present the first reported case with typical endoscopic and histological findings from thailand. An 80-year-old man presented with chronic periumbilical abdominal pain for 3 months and melena for one week. He had had hypertension for 17 years, chronic renal failure for 4 years and gouty arthritis for 3 years. Panendoscopy was done and showed diffusely scattered small black and brown pigmentation over the stomach and duodenum. Tissue biopsies from the black pigmented lesions were taken for further microscopic and histochemical evaluation. Histological finding and special histochemical stains, Fontana stain, revealed mild chronic inflammation with accumulation of hemosiderin pigment in the lamina propria of the stomach and duodenal villi. This condition is called Pseudomelanosis duodeni. The literature of this condition was also reviewed.- - - - - - - - - - ranking = 0.066666666666667keywords = arthritis (Clic here for more details about this article) |
6/55. An unusual systemic presentation of gout.An elderly female presented with a systemic febrile illness and acute polyarthritis as the first manifestation of gout. She improved dramatically with anti-inflammatory therapy.- - - - - - - - - - ranking = 0.066666666666667keywords = arthritis (Clic here for more details about this article) |
7/55. Acute paraplegia in a patient with spinal tophi: a case report.A 28-year-old man with a 5-year history of gouty arthritis suffered from an acute episode of lower back pain. He visited a rehabilitative clinic and received physical therapy following his examination. Weakness and numbness of both lower legs developed rapidly after physical therapy. He was sent to our hospital with complete paralysis of both lower limbs and complete sensory loss below the umbilicus 3 hours after the physical therapy. No peripheral tophi were found. myelography showed an extrinsic compression of the dura sac at T10. Emergency decompressive laminectomy of T9 to T11 was performed. During the surgery, caseous material was found deposited in the ligamentum flavum and the left T9 to T10 facet joint, with indentation of the dura sac. The pathologic diagnosis was spinal tophi. After surgery, the patient's neurologic function recovered rapidly. It was suspected that inappropriate physical therapy might have aggravated acute inflammation of spinal gout and resulted in a rapid deterioration of neurologic function. Though gout is a chronic medical disease, an acute attack of spinal gout may be disastrous and requires emergency neurosurgical intervention.- - - - - - - - - - ranking = 0.066666666666667keywords = arthritis (Clic here for more details about this article) |
8/55. Inflammatory pseudotumor of the liver complicated with recurrent gouty arthritis.Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion of unknown etiology and is often accompanied by fever. Unexplained persistent fever unresponsive to antibiotics developed in a 70-year-old man suffering from intractable recurrent gouty arthritis. 67Ga-scintigraphy disclosed intense focal uptake in the upper abdomen. The lesion in the left lobe of the liver was an ill-defined hypodensity mass on computed tomographic scan and was enhanced on dynamic magnetic resonance imaging. The tumor was surgically removed and a diagnosis of IPT was made. fever and arthritis resolved completely after surgery. Possible interaction between IPT of the liver and gouty arthritis was suggested.- - - - - - - - - - ranking = 0.46666666666667keywords = arthritis (Clic here for more details about this article) |
9/55. Chronic myeloid leukemia presenting as gout.A 53-year-old man presented with gouty arthritis. A physical examination and haematological and biochemical tests showed that he had chronic myeloid leukemia. He was treated with allopurinol, hydroxyurea and analgesics. The arthritis subsided completely within 2 weeks. He continues in haematologic remission (on interferon) with no further recurrence of the gout.- - - - - - - - - - ranking = 0.13333333333333keywords = arthritis (Clic here for more details about this article) |
10/55. Chronic tophaceous gout presenting as hyperpigmented nodules in the limbs of a patient with coexisting psoriasis.We describe a 53-year-old male renal transplant recipient with hypertension and triglyceridemia, who showed rare manifestations of gout presenting as brownish nodules on the arms and legs as well as chronic tophaceous gouty arthritis of the hands and feet mimicking rheumatoid arthritis, in association with subsequently developed psoriasis of the palms. In elderly Asian men, hypertension and renal insufficiency may be risk factors predisposing to the development of multiple hyperpigmented nodules of tophi in the more proximal extremities.- - - - - - - - - - ranking = 0.13333333333333keywords = arthritis (Clic here for more details about this article) |
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