Young Onset Polyarticular Tophaceous Gout: Rare and Aggressive

Rana, Deepshikha; Momin, Zeany C

doi:10.7759/cureus.16954

Cited by 1 publication

(1 citation statement)

References 6 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise, those who defer treatment usually develop a second flare within two years due to the persistently elevated serum uric acid levels. Moreover, shorter asymptomatic periods have been observed later in the disease course [14]. Acute gout is a distressing and crippling state which can lead to joint erosion if left untreated.…”

Section: Introductionmentioning

confidence: 99%

An Unusual and Rare Presentation of Diffuse Tophaceous Gout

Levy-Bedoya¹,

Noa²,

Dewan³

et al. 2022

Cureus

View full text Add to dashboard Cite

Gout is a chronic disease characterized by recurrent attacks on joints from monosodium urate crystal deposition causing inflammation and severe pain. Patients at increased risk of developing gout include those with obesity, high consumption of alcohol or high-purine foods, genetic causes, and medication side effects. Typically, there are three stages of disease progression: acute, inter-critical, and chronic. Monoarticular joint disease is common however polyarticular gouty arthritis can result after years of acute flares. The chronic nature of the disease forms tophi, which are generally painless solid urate crystal collections. We present an unusual case of a 33-year-old male whose initial presentation was severe tophaceous gout affecting multiple joints, including bilateral elbows, knees, as well as hand and foot joints. His presentation was unique in that the tophi were not firm as expected, but were erythematous, tender, and fluctuant resembling an abscess. Laboratory and imaging studies confirmed the diagnosis of tophaceous gout and the patient's symptoms improved after starting systemic steroid therapy and colchicine. A multidisciplinary effort involving the medicine team and infectious disease, podiatry, and rheumatology consultants was essential in reaching the diagnosis. This case highlights the importance of keeping a broad differential diagnosis in a patient with polyarticular lesions and considering gout even with an atypical presentation such as in our patient.

show abstract

Section: Introductionmentioning

confidence: 99%