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Related Experiment Videos

Flexor tendon rupture caused by gout: a case report.

Raymond K Wurapa1, David S Zelouf

  • 1Department of Orthopedics, Division of Hand Surgery, The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA, USA.

The Journal of Hand Surgery
|July 20, 2002
PubMed
Summary

This study details a rare case of gout affecting hand tendons, leading to rupture of both flexor digitorum superficialis and profundus tendons. Management involved a single-stage tendon reconstruction, highlighting gout as a potential cause of tendon insufficiency.

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Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Hand Surgery

Background:

  • Gout is a common metabolic disorder characterized by hyperuricemia and urate crystal deposition.
  • While gout commonly affects joints, urate crystal deposition in tendons (gouty tophi) is less frequent.
  • Tendon involvement in gout can lead to inflammation, rupture, and functional deficits.

Observation:

  • A unique case of primary gouty infiltration affecting flexor tendons in a single digit of the hand is presented.
  • The infiltration resulted in the simultaneous rupture of both the flexor digitorum superficialis and flexor digitorum profundus tendons.
  • The affected digit demonstrated significant tendon insufficiency due to the gout-induced damage.

Findings:

  • Surgical management involved a single-stage reconstruction of the less compromised flexor digitorum superficialis tendon.

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  • A segment of the proximal flexor digitorum profundus tendon stump was utilized as a bridge graft for the reconstruction.
  • Histopathological examination confirmed urate crystal deposition within the tendon substance, establishing primary gouty infiltration.

    • Implications:

    • This case underscores the importance of considering primary gouty infiltration as an uncommon etiology for flexor tendon ruptures in the hand.
    • Clinicians should maintain a high index of suspicion for gouty tendon involvement in patients with a history of gout presenting with tendon insufficiency.
    • Early recognition and appropriate management can potentially improve outcomes for patients with this rare condition.