After written informed consent was obtained from the patient, under general anesthesia, marginal resection of tophi
were performed bilaterally in the same session with clear margins (Figure 4).
The dual-energy computed tomography (DECT) showed multiple tophi
in both hands with erosions in the bones and malformations in the joints [Figure 1]a,[Figure 1]b,[Figure 1]c,[Figure 1]d,[Figure 1]e.
level, the faster the crystal deposits (and tophi
However, prior to our recognition that our patient had CECS, case reports of carpal tunnel syndrome caused by gouty tophi
[12-15] led us to consider the possibility that he had accumulated nonsynovial tophi
(e.g., within the fascia) that precipitated ACS by reducing compliance of the fascia.
We concluded that tophi
around the bipartite patella should be treated by a combination of surgical excision and uricosuric agents to prevent deposition causing recurrence of gouty attacks and to preserve the second part of patella as much as possible.
Fully 52% of trial participants had chronic kidney disease, and 44% had tophi
. "Thus, our population is representative of people with gout, represents real-life clinical practice, and the results are generalizable to other gout populations," the investigators wrote.
seen in long-term disease are generally located in the elbow, forearm, Achilles tendon or the external ear, and can give rise to various symptoms by compressing the surrounding tissues.3,4 There are only a few cases reported in literature regarding cubital tunnel syndrome caused by tophi
in the elbow.3-5 Even though conditions such as pain, numbness and muscular weakness in the forearm are rare in patients with gout, cubital tunnel syndrome caused by tophaceous compression should still be considered.
Characteristic features of joint damage boney erosions are new bone formation, tophi
within tendons, and focal cartilage loss with eventual joint destruction .
Phase (3) shows the formation of aggregated NETs (aggNET) that provide the structural basis of gouty tophi
and contain high concentration of PMN proteases degrading PMN chemoattractants.
Physical examination revealed obvious subcutaneous tophi
and thenar muscle wasting.
cause erosions of joints, but also deposit in the skin and soft tissue, including the bursae, tendons and articular cartilage.
Urate-lowering medications should be initiated to reduce recurrent attacks and bony formations as well as to dissolve any tophi
that may have formed.