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Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report
Evangelos Falidas1, Efstathios Rallis, Vasiliki-Kalliopi Bournia
1First Department of Surgery, 417 NIMTS Veterans Administration Hospital of Athens, Monis Petraki 10-12, Athens, 11521,Greece. falidase@otenet.gr.
Journal of Medical Case Reports
|August 23, 2011
Summary
This case study highlights rare ulcerated tophi in a gout patient, emphasizing that such complications are uncommon with modern hyperuricemia treatments. Surgical intervention for gout is typically reserved for severe, persistent cases.
Area of Science:
- Rheumatology
- Dermatology
Background:
- Gout is a prevalent inflammatory arthritis characterized by monosodium urate crystal deposition.
- Typically affecting the first metatarsophalangeal joint, gout can also involve other joints like wrists, elbows, knees, and ankles.
Purpose of the Study:
- To present a case of tophaceous gout with unusual soft-tissue and ulcerated tophi involvement.
- To discuss the rarity of such ulcerations in the context of current gout management.
Main Methods:
- Case report of a 75-year-old Caucasian male.
- Detailed description of tophaceous gout affecting multiple joints and soft tissues, including ulcerated tophi.
Main Results:
- The patient presented with ulcerated tophi on the first metatarsophalangeal joint of the left foot, the first interphalangeal joint of the right foot, and the left thumb.
- This presentation signifies a rare manifestation of tophaceous gout.
Conclusions:
- Ulcerated tophi in gout are uncommon due to effective pharmaceutical control of hyperuricemia.
- Surgical treatment for gout is rarely needed and generally indicated for recurrent attacks, deformities, severe pain, infection, or joint destruction.
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