Chronic Intratendinous Tophaceous Gout in Repaired Second Extensor Digitorum Communis and Extensor Indicis Proprius...

A 26-year-old male patient visited outpatient clinic for pain and palpable mass at 2nd extensor digitorum communis zone V region since last year. He underwent a posttraumatic extensor tenorrhaphy on the same location 11 years ago. Otherwise previously healthy, his blood test revealed an elevated uric acid level. Preoperative magnetic resonance imaging scan suggested a lesion, such as tenosynovial hemangioma and neurogenic tumor. Excisional biopsy was performed, and total excision of the compromised second extensor digitorum communis and extensor indicis proprius tendons was also necessary. Palmaris longus tendon was grafted to the defect. Postoperative biopsy report confirmed a crystalloid material with giant cell associated granulomas, suggestive of gouty tophi.