Gout is a metabolic disorder that is characterized by a deposition of monosodium urate crystals in the joint or soft tissue. Gout manifestations in head and neck region are rare, and larynx is an infrequently affected...Gout is a metabolic disorder that is characterized by a deposition of monosodium urate crystals in the joint or soft tissue. Gout manifestations in head and neck region are rare, and larynx is an infrequently affected location. We recently managed a case of a gouty tophus over the larynx. A 65-year-old male with a long history of gout without medical control. He has suffered from increasing hoarseness for six months. Laryngoscopy revealed a mass lesion over the right vocal process region without vocal paralysis. Laryngo-micro-surgery biopsy was taken, and pathology confirmed laryngeal gouty tophus without evidence of malignancy.展开更多
A case of gouty tophus in the elbow of a 62-year-old male is presented. Fine-needle aspiration (FNA) revealed the presence of acicular crystals, birefringent when viewed under polarized light as is typical for monosod...A case of gouty tophus in the elbow of a 62-year-old male is presented. Fine-needle aspiration (FNA) revealed the presence of acicular crystals, birefringent when viewed under polarized light as is typical for monosodium urate crystals. Histological study of the removed lesion confirmed a typical gouty tophus. We briefly comment the main characteristics of this entity.展开更多
Rheumatoid arthritis (RA) and gout are common diseases, but their coexistence is rare. We describe the case of a 76-year-old man with hypertension who had been treated for gout for 20 years on allopurinol and colchici...Rheumatoid arthritis (RA) and gout are common diseases, but their coexistence is rare. We describe the case of a 76-year-old man with hypertension who had been treated for gout for 20 years on allopurinol and colchicine. He was seen in consultation for deforming polyarthritis of the small and large joints, which had been evolving for about 2 years. The acute episode occurred 10 days earlier with the onset of bilateral and symmetrical polyarthritis affecting the large and small joints. The physical examination revealed a peripheral joint syndrome with ulnar gale force deformities of the hands and several buttonhole deformities of the fingers. In addition, there were nodules, some of which were fistulised, giving rise to a chalky slurry. The biology revealed an inflammatory syndrome in addition to rheumatoid factors and ACPA, which were elevated. Biological analysis of the nodular fluid revealed clusters of sodium urate crystals and ultrasound scans of the joints revealed a double-contour appearance in several joints. The diagnosis of RA was made using the 2010 ACR/EULAR criteria. The patient was treated as an outpatient with corticosteroids before being put on methotrexate. It is important to understand that these two conditions can occur at the same time, so it is important to consider them when treating patients with gout or RA.展开更多
The management of gouty tophi has generally shifted from surgical excision to conservative therapy due to surgery’s traditional association with high wound complication rate. Yet there are still patients who are indi...The management of gouty tophi has generally shifted from surgical excision to conservative therapy due to surgery’s traditional association with high wound complication rate. Yet there are still patients who are indicated for surgical excision of gouty tophi, including for functional or cosmetic reasons. We describe our surgical technique and clinical outcomes in patients who underwent gouty tophi excision. This technique includes near complete excision of non-infected gouty tophi with preservation of important soft tissue structures. We have performed 44 elective tophi excision surgery in ten patients with an average follow-up of 29 months. The overall patients’ satisfaction rate was 90%. Only one post-operative infection was noted. No recurrence was observed. Our results suggested that this technique is a safe and effective option for a selected group of patients suffering from tophaceous gout.展开更多
文摘Gout is a metabolic disorder that is characterized by a deposition of monosodium urate crystals in the joint or soft tissue. Gout manifestations in head and neck region are rare, and larynx is an infrequently affected location. We recently managed a case of a gouty tophus over the larynx. A 65-year-old male with a long history of gout without medical control. He has suffered from increasing hoarseness for six months. Laryngoscopy revealed a mass lesion over the right vocal process region without vocal paralysis. Laryngo-micro-surgery biopsy was taken, and pathology confirmed laryngeal gouty tophus without evidence of malignancy.
文摘A case of gouty tophus in the elbow of a 62-year-old male is presented. Fine-needle aspiration (FNA) revealed the presence of acicular crystals, birefringent when viewed under polarized light as is typical for monosodium urate crystals. Histological study of the removed lesion confirmed a typical gouty tophus. We briefly comment the main characteristics of this entity.
文摘Rheumatoid arthritis (RA) and gout are common diseases, but their coexistence is rare. We describe the case of a 76-year-old man with hypertension who had been treated for gout for 20 years on allopurinol and colchicine. He was seen in consultation for deforming polyarthritis of the small and large joints, which had been evolving for about 2 years. The acute episode occurred 10 days earlier with the onset of bilateral and symmetrical polyarthritis affecting the large and small joints. The physical examination revealed a peripheral joint syndrome with ulnar gale force deformities of the hands and several buttonhole deformities of the fingers. In addition, there were nodules, some of which were fistulised, giving rise to a chalky slurry. The biology revealed an inflammatory syndrome in addition to rheumatoid factors and ACPA, which were elevated. Biological analysis of the nodular fluid revealed clusters of sodium urate crystals and ultrasound scans of the joints revealed a double-contour appearance in several joints. The diagnosis of RA was made using the 2010 ACR/EULAR criteria. The patient was treated as an outpatient with corticosteroids before being put on methotrexate. It is important to understand that these two conditions can occur at the same time, so it is important to consider them when treating patients with gout or RA.
文摘The management of gouty tophi has generally shifted from surgical excision to conservative therapy due to surgery’s traditional association with high wound complication rate. Yet there are still patients who are indicated for surgical excision of gouty tophi, including for functional or cosmetic reasons. We describe our surgical technique and clinical outcomes in patients who underwent gouty tophi excision. This technique includes near complete excision of non-infected gouty tophi with preservation of important soft tissue structures. We have performed 44 elective tophi excision surgery in ten patients with an average follow-up of 29 months. The overall patients’ satisfaction rate was 90%. Only one post-operative infection was noted. No recurrence was observed. Our results suggested that this technique is a safe and effective option for a selected group of patients suffering from tophaceous gout.
