Multiple extensor tendon ruptures caused by tophaceous gout

Iwamoto, Takuji; Toki, Hiroe; Ikari, Katsunori; Yamanaka, Hisashi; Momohara, Shigeki

doi:10.1007/s10165-009-0258-x

Cited by 10 publications

(13 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tophi are typically found on the helix of the ears, on fingers, toes, wrists and knees, on the olecranon bursae, on the Achilles tendons and also rarely on the sclerae, subconjuctivally, [4] and on the cardiac valves [5]. They can cause pain and dysfunction and are rarely associated with ulcerations [6], bone fractures [7], tendon and ligament rupture [8], carpal tunnel [9] and other nerve compression syndromes [10]. Differential diagnosis for subcutaneous or articular nodules includes septic arthritis, synovial cysts, nodal osteoarthritis, rheumatoid arthritis, sarcoidosis, lymphoma or neoplasms [11].…”

Section: Discussionmentioning

confidence: 99%

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

et al. 2011

View full text Add to dashboard Cite

IntroductionGout is a common inflammatory arthritis caused by articular precipitation of monosodium urate crystals. It usually affects the first metatarsophalangeal joint of the foot and less commonly other joints, such as wrists, elbows, knees and ankles.Case presentationWe report the case of a 75-year-old Caucasian man with tophaceous multiarticular gout, soft-tissue involvement and ulcerated tophi on the first metatarsophalangeal joint of the left foot, on the first interphalangeal joint of the right foot and on the left thumb.ConclusionUlcers due to tophaceous gout are currently uncommon considering the positive effect of pharmaceutical treatment in controlling hyperuricemia. Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain, infection and joint destruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

et al. 2011

View full text Add to dashboard Cite

show abstract

“…There have been reports that gouty tophi in the upper extremity were surgically resected because of entrapment neuropathy [ 12 ], flexion deformity of the finger [ 13 ], or tendon ruptures. To the best of our knowledge, there have been only 5 reports of hand or wrist tendon ruptures due to gout [ 4 , 14 – 17 ]. A few extensor tendon rupture cases have been reported [ 4 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, there have been only 5 reports of hand or wrist tendon ruptures due to gout [ 4 , 14 – 17 ]. A few extensor tendon rupture cases have been reported [ 4 , 14 , 15 ]. In one case, a painless subcutaneous tumor caused rupture of the common digital extensor muscle tendon followed by poor extension of the ring finger [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, poor control of hyperuricemia can result in a heavy tophus in some cases [ 1 – 3 ]. In general, spontaneous tendon rupture in the hand occurs in association with rheumatoid arthritis, distal radius fractures, or osteoarthritis of the distal radioulnar joint [ 4 ]. There have been only a few reports of tendon rupture in the hand or wrist due to gout.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multiple Tophaceous Gout of Hand with Extensor Tendon Rupture

Tobimatsu

Nakayama

Sakuma

et al. 2017

Case Reports in Orthopedics

Self Cite

View full text Add to dashboard Cite

A 45-year-old man presented with painless subcutaneous masses bilaterally on his hands and loss of motion or contracture of the fingers. Initially, drug therapy to reduce the serum uric acid was administered and was expected to reduce the tophi. However, during observation at the clinic, spontaneous rupture of an extensor tendon occurred, and surgical repair of the tendon and resection of the masses were performed. Surgical exploration of the right hand showed hypertrophic white-colored crystal deposits that both surrounded and invaded the extensor digitorum communis of the index finger, which was ruptured. Histopathologic examination of the specimen demonstrated findings consistent with gouty tophi. Tophaceous gout can induce a rupture of tendons during clinical observation, and surgical resection of the tophi might be needed to prevent ruptures.

show abstract

“…This procedure is contraindicated for huge tophi for which endoscopic resection is time-consuming and excision of the excessive skin is needed. It is also contraindicated if active sepsis is present, the diagnosis is doubtful, or complex surgical reconstruction is needed, for example, in the presence of tendon rupture 12 or gross destruction of the underlying bone and joint ( Table 1). The purpose of this Technical Note is to describe a minimally invasive approach to decompression of a gouty tophus of the hand dorsum under direct endoscopic visualization.…”

mentioning

confidence: 99%

Endoscopic Decompression of a Gouty Tophus at the Hand Dorsum

Lui¹

2017

Arthroscopy Techniques

View full text Add to dashboard Cite

Medical treatment including lifestyle and dietary modifications and drug therapy remains the mainstay of treatment for gouty arthritis of the hand and wrist. Without proper and timely treatment, tophi develop approximately 10 years after the onset of the disease. Open surgery for tophaceous gout is associated with a relatively high rate of complications particularly related to the surgical wound and overlying skin necrosis. Intralesional shaving of the tophi through small incisions has been reported and has the advantage of fewer wound complications. However, this is a blind procedure, and the underlying tendons and neurovascular bundles are at risk. The purpose of this Technical Note is to report an endoscopic approach to debulking a gouty tophus at the hand dorsum. This allows the minimally invasive debulking procedure to be performed under endoscopic visualization and reduces the risk of injury to the tendon and neurovascular structures.

show abstract

Multiple extensor tendon ruptures caused by tophaceous gout

Cited by 10 publications

References 7 publications

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

Multiple Tophaceous Gout of Hand with Extensor Tendon Rupture

Endoscopic Decompression of a Gouty Tophus at the Hand Dorsum

Contact Info

Product

Resources

About