Peroneus brevis tendon rupture with tophaceous gout infiltration

Area of Science:

• Orthopedics
• Rheumatology
• Sports Medicine

Background:

• Chronic lateral ankle instability is a common condition often associated with pain and functional deficits.
• Peroneus brevis tendon tears and anterior talofibular ligament (ATFL) injuries can contribute to ankle instability.
• Gout, a form of inflammatory arthritis, can affect joints throughout the body, including the ankle.

Observation:

• A patient with chronic ankle instability presented with anterior ankle pain and weakness.
• Diagnostic imaging, including MRI, revealed an attenuated ATFL and a longitudinal tear of the peroneus brevis tendon.
• Surgical exploration identified tophaceous gout deposits within both the ATFL and the peroneus brevis tendon tear.

Findings:

• This case presents an unusual association between tophaceous gout and structural ankle pathology.
• Gout infiltration was observed within a longitudinal peroneus brevis tendon tear and an attenuated ATFL.
• The findings suggest gout can mimic or exacerbate common causes of ankle instability.

Implications:

• This case broadens the differential diagnosis for chronic ankle pain and instability.
• Recognizing gout as a potential cause of tendon and ligament pathology is crucial for accurate diagnosis and treatment.
• Further research may elucidate the mechanisms by which gout affects tendons and ligaments in the context of ankle instability.