Tophaceous gout of the first costochondral junction in a heart transplant patient

Abstract

We report the case of a 49-year-old man with a 10-year history of gout, who presented with a painful left first costochondral junction mass. A computed tomography (CT)-guided biopsy of the mass revealed foreign body giant cell reaction and crystalline deposition consistent with tophaceous gout.

Treatment of gout in patients after organ transplantation

“…Częste jest zajęcie nietypowych miejsc, np. stawów krzyżowo-biodrowych, kręgosłupa, stawów ręki, przyczepów żeber do mostka, co stwarza trudności diagnostyczne [9,[13][14][15].…”

Involvement of anterior chest structures accompanied with chest pain in patients with gout

“…Of all the sites of gout attacks, the sternoclavicular joint was the most common ( n = 4), the others being the costal cartilage ( n = 2) and manubriosternal joint ( n = 2). Almost all patients presented with anterior chest pain accompanied by localized joint swelling, and in some patients with pain that mimicked myocardial infarction and pleurisy [ 2 , 6 ]. In addition, some patients presented with night sweats, fever, and other symptoms similar to sternal tuberculosis and infection [ 4 – 6 ].…”

“…Almost all patients presented with anterior chest pain accompanied by localized joint swelling, and in some patients with pain that mimicked myocardial infarction and pleurisy [ 2 , 6 ]. In addition, some patients presented with night sweats, fever, and other symptoms similar to sternal tuberculosis and infection [ 4 – 6 ]. The main tools for confirming the diagnosis include joint aspiration for polarizing microscopy, mass excision biopsy, and dual-energy CT (DECT).…”

“…After screening the titles and abstracts and the references of the included papers, eight articles were found to be relevant. The eligible articles included 8 case reports [2][3][4][5][6][7][8][9]. A total of 8 patients were identified, with a male/female ratio of 7/1 and a mean age of 52 years (range: 44-61), with a median age of 52 years (Table I).…”