Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout

Tophaceous gout is a crystal arthropathy and a disorder of purine metabolism characterized by monosodium urate crystal deposition. A case of tophaceous gout of the knee joint in a 30-year-old female is reported, and the imaging appearances on high-resolution ultrasonography are described. The patien...

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Main Author: Ravikanth Reddy
Format: Article
Language:English
Published: Knowledge E 2021-10-01
Series:Dubai Medical Journal
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Online Access:https://www.karger.com/Article/FullText/519571
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author Ravikanth Reddy
author_facet Ravikanth Reddy
author_sort Ravikanth Reddy
collection DOAJ
description Tophaceous gout is a crystal arthropathy and a disorder of purine metabolism characterized by monosodium urate crystal deposition. A case of tophaceous gout of the knee joint in a 30-year-old female is reported, and the imaging appearances on high-resolution ultrasonography are described. The patient presented with complaints of insidious onset painless swelling of the left knee joint with limitation of range of movement for 1 week. The aspirated joint fluid demonstrated needle-like monosodium urate crystals showing strong negative birefringence consistent with a diagnosis of tophaceous gout. Targeted urate-lowering treatment included oral nonsteroidal anti-inflammatory drugs and oral colchicine. Prophylactic treatment for gout flare-ups included initiation of allopurinol at 300 mg/day along with modification of the dietary regimen including limited consumption of red meat and increased consumption of low-fat dairy products. Symptomatic improvement with reduced pain and swelling of the knee joint was noted at 10 days after treatment. Subsequently, at 3-month follow-up, the patient was disease free with no signs of recurrence and serum uric acid levels at 3.7 mg/dL. In spite of a wide range of therapeutic options available for the management of tophaceous gout, suboptimal management of gout is prevalent till date in both developing and developed nations across the world.
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spelling doaj-art-fa7de4b6aad541078197d0dbc768b2b22025-08-20T02:43:55ZengKnowledge EDubai Medical Journal2571-726X2021-10-011510.1159/000519571519571Monoarticular Crystal Arthropathy of the Knee: Tophaceous GoutRavikanth Reddyhttps://orcid.org/0000-0003-0879-6181Tophaceous gout is a crystal arthropathy and a disorder of purine metabolism characterized by monosodium urate crystal deposition. A case of tophaceous gout of the knee joint in a 30-year-old female is reported, and the imaging appearances on high-resolution ultrasonography are described. The patient presented with complaints of insidious onset painless swelling of the left knee joint with limitation of range of movement for 1 week. The aspirated joint fluid demonstrated needle-like monosodium urate crystals showing strong negative birefringence consistent with a diagnosis of tophaceous gout. Targeted urate-lowering treatment included oral nonsteroidal anti-inflammatory drugs and oral colchicine. Prophylactic treatment for gout flare-ups included initiation of allopurinol at 300 mg/day along with modification of the dietary regimen including limited consumption of red meat and increased consumption of low-fat dairy products. Symptomatic improvement with reduced pain and swelling of the knee joint was noted at 10 days after treatment. Subsequently, at 3-month follow-up, the patient was disease free with no signs of recurrence and serum uric acid levels at 3.7 mg/dL. In spite of a wide range of therapeutic options available for the management of tophaceous gout, suboptimal management of gout is prevalent till date in both developing and developed nations across the world.https://www.karger.com/Article/FullText/519571tophaceous goutfemale patienthigh-resolution ultrasonographyknee jointmonosodium urate crystals
spellingShingle Ravikanth Reddy
Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout
Dubai Medical Journal
tophaceous gout
female patient
high-resolution ultrasonography
knee joint
monosodium urate crystals
title Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout
title_full Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout
title_fullStr Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout
title_full_unstemmed Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout
title_short Monoarticular Crystal Arthropathy of the Knee: Tophaceous Gout
title_sort monoarticular crystal arthropathy of the knee tophaceous gout
topic tophaceous gout
female patient
high-resolution ultrasonography
knee joint
monosodium urate crystals
url https://www.karger.com/Article/FullText/519571
work_keys_str_mv AT ravikanthreddy monoarticularcrystalarthropathyofthekneetophaceousgout