Acute Tophaceous Gout of the Distal Interphalangeal Joint Misdiagnosed as Cellulitis.
10.4055/jkoa.2013.48.1.38
- Author:
Soo Min CHA
1
;
Kyung Cheon KIM
;
Hyun Dae SHIN
Author Information
1. Department of Orthopaedic Surgery, Research Institute for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea. hyunsd@cnu.ac.kr
- Publication Type:Case Report
- Keywords:
finger joint;
hand;
gout
- MeSH:
Aged;
Allopurinol;
Cellulitis;
Finger Joint;
Gout;
Hand;
Humans;
Incidence;
Joint Capsule;
Joints;
Male;
Skin;
Tendons
- From:The Journal of the Korean Orthopaedic Association
2013;48(1):38-42
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In elderly patients, the first incidence of gout often affects the distal interphalangeal joint (DIP) and usually subsides without specific treatment after about 7 days. A 61-year-old male was presented to our clinic with a 10-day history of tenderness and swelling in his index DIP, which was initially diagnosed as cellulitis. After a skin incision was made to drain the lesion, typical tophaceous deposits were observed around the extensor apparatus, flexor tendons, and joint capsule. The tophi were meticulously removed in order to minimize the injury to its surrounding structures, after which the joint fluid was aspirated. There was no history of gout, laboratory findings suggesting tophaceous gout, or apparent predisposing factors in the patient's history. Pathology confirmed tophaceous deposits and negative birefringent crystals, and the patient has been managed on allopurinol for post-operative six months.
