Lytic Bone Lesions: Osteomyelitis or Intraosseous Gout?

An, Jason; Troster, Sarah M

doi:10.3899/jrheum.170125

Cited by 3 publications

(3 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is very important to make the distinction between gouty arthritis and osteomyelitis early with bone biopsy or needle aspiration if imaging or clinical presentation is questionable, so there is no delay in appropriate treatment. Dual-energy computed tomography (DECT) is an imaging technique with a sensitivity of up to 85% and specificity of 93% for MSU crystals, and in the right clinical setting, can help make this differentiation early on 11. DECT may be unhelpful in a case like ours where both conditions were present simultaneously.…”

Section: Discussionmentioning

confidence: 93%

“…Our case is also the first case reported to have C. koseri osteomyelitis and concomitant acute gouty arthritis affecting the same joint. Lytic lesions caused by osteomyelitis and intra-osseous gout may look similar making it difficult to differentiate between the two 11. Rousseau et al reported five cases where osteomyelitis was initially suspected and treated accordingly based on imaging.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Citrobacter kosericausing osteomyelitis in a diabetic foot with concomitant acute gouty arthritis successfully treated with ertapenem

Tinevez

Knezevic²

2019

BMJ Case Rep

View full text Add to dashboard Cite

We present an elderly diabetic man with left hallux pain and drainage who was initially diagnosed with acute gouty arthritis using the diagnostic rule for acute gout and monosodium urate crystals presented on synovial fluid analysis. Further investigation with surgical debridement, plain X-ray, MRI and wound culture revealed concomitant Citrobacter koseri septic arthritis with osteomyelitis. C. koseri is considered an opportunistic infection that rarely causes musculoskeletal infections. Acute gouty arthritis and septic arthritis are rarely seen occurring concomitantly in the same joint and are often difficult to differentiate due to similar findings on exam and imaging. The present case illustrates that osteomyelitis with an opportunistic organism can present concomitantly with acute gouty arthritis, and the diagnosis of one should not exclude the other.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Citrobacter kosericausing osteomyelitis in a diabetic foot with concomitant acute gouty arthritis successfully treated with ertapenem

Tinevez

Knezevic²

2019

BMJ Case Rep

View full text Add to dashboard Cite

show abstract

“…Intraosseous appearance of gout presenting as lytic lesions is challenging in diagnostic management [62]. For demarcation of osteomyelitis or intraosseous tumors dual energy computed tomography and/or MRI is the method of choice [7,63,64]. However, histological examination of intraoperatively taken specimens before definite surgical treatment is strictly recommended in order to avoid a failed treatment ( Figure 7A-7B) [65].…”

Section: Clinical Presentation and Differential Diagnoses Of Goutmentioning

confidence: 99%

Gout – Practicable Interdisciplinary Insights for the Clinician on a Surgeon’s Perspective

Schmidt¹

2018

JRAD

View full text Add to dashboard Cite

Gout is a common systemic metabolic disease caused either by increased uric acid production or by decreased uric acid excretion potentially leading to crystal deposition of monosodium urate in various tissues and resulting in acute gouty attacks mainly initially presenting as mono arthritis of joints. The further course can be accompanied with development of chronic tophaceous gout with or without complications such as skin perforation of tophi accompanied with occurrence of chronic fistula and overlying bacterial infection. When the diagnostic management was early and sufficiently done, it can be successfully treated by specific drugs in most cases, and approximately in up to 5% of cases only surgical intervention becomes necessary that includes various extremity-and motion-preserving procedures, but in life threatening conditions primary amputation as well. The aim of this article is to present practicable interdisciplinary insights of the disease for clinicians on a view of a surgeon.

show abstract

Intraosseous tophaceous gout - femur

Deng¹,

Ho²

2018

Radiopaedia.org

View full text Add to dashboard Cite

Lytic Bone Lesions: Osteomyelitis or Intraosseous Gout?

Cited by 3 publications

References 2 publications

Citrobacter kosericausing osteomyelitis in a diabetic foot with concomitant acute gouty arthritis successfully treated with ertapenem

Citrobacter kosericausing osteomyelitis in a diabetic foot with concomitant acute gouty arthritis successfully treated with ertapenem

Gout – Practicable Interdisciplinary Insights for the Clinician on a Surgeon’s Perspective

Intraosseous tophaceous gout - femur

Contact Info

Product

Resources

About