Chronic high uric acid levels in gout cause the patella bone to thin progressively
Medical literature documents rare instances of osteolytic lesions and tophi in the patella associated with gout, but evidence is insufficient to confirm that chronic uric acid levels cause progressive patellar bone thinning.
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Chronic Tophaceous Gout Presenting as Bilateral Knee Masses in an Adult Patient: A Case Report.. 2019. https://doi.org/10.13107/jocr.2019.v09.i05.1512
<h4>Introduction</h4>Gout is a common disorder of uric acid metabolism that leads to the precipitation of monosodium urate crystals. It most commonly affects the first metatarsophalangeal joint but can also affect other joints such as knees, elbows, wrists, and ankles. Chronic gout can present as recurrent episodes of monoarticular or polyarticular inflammatory arthritis, tophaceous soft tissue deposits of monosodium urate crystals, uric acid renal calculi, and/or chronic nephropathy.<h4>Case report</h4>We report the case of a 67-year-old Caucasian male patient with bilateral tophaceous gout to his knees involving the soft tissue and ulcerating skin breakdown to his left knee after an acute traumatic injury. Plain radiographs of the bilateral knees revealed large soft tissue masses anterior to the patella. Magnetic resonance imaging of the left knee was also performed which demonstrated heterogeneous masses consistent with tophi and peripheral enhancement with central necrosis. A diagnostic biopsy was performed to rule out malignancy the results confirmed gouty tophi. We report this case to note the atypical presentation of this disease.<h4>Conclusion</h4>Chronic tophaceous gout presenting with ulcerating skin breakdown overlying a fungating tophaceous mass is uncommon considering the current availability of effective pharmaceutical treatments for hyperuricemia. Surgical intervention for tophaceous gout is seldom required and is traditionally reserved for atypical cases that present with deformities, severe pain, and joint destruction. Although ulcerative tophi are rare, they can have significant morbidity and greatly impact patients' quality of life. Surgical intervention was indicated in our patient to excise the mass and avoid infective complications.
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Intraosseus Tophaceous Gout of the Patella. A Case Report and Review of the Literature. https://doi.org/10.26717/bjstr.2021.33.005395
# Intraosseus Tophaceous Gout of the Patella. A Case Report and Review of the Literature Biomedical Journal of Scientific & Technical Research. Published: 2021-01-26. 0 citations. ## Authors - Joan Pijoan (Universitat Autònoma de Barcelona): h-index 3; 58 citations; corresponding author ## Topics - Sports injuries and prevention - Musculoskeletal synovial abnormalities and treatments - Gout, Hyperuricemia, Uric Acid --- # Intraosseus Tophaceous Gout of the Patella. A Case Report and Review of the Literature ## Abstract Patellar bone tumors are rare entities. The differential diagnosis is extensive, including both benign and malignant tumors. Intraosseous gout tophi should be considered. The clinical and imaging features of this entity are unspecific, although in some cases it may carry a high suspicion diagnostic. We present a case of patella gout tophi who's clinical and imaging tests raised diagnostic questions, so an excisional biopsy was performed for diagnosis and treatment. ## Introduction Patellar tumors are rare entities, representing only 0.12% of all bone tumors in the United States. The 70% of all patella tumors are benign, with giant cell tumor and chondrobla
Isolated or dominant lesions of the patella in gout: a report of seven patients. https://pubmed.ncbi.nlm.nih.gov/8191294/
Isolated or dominant lesions of the patella in gout: a report of seven patients ## Abstract Isolated or dominant osteolytic lesions of the patella are an unusual manifestation of gout. We present seven patients who had such patellar lesions unilaterally (six patients) or bilaterally (one patient) and analyze the radiologic characteristics to determine whether they can be differentiated from those of other osteolytic lesions of the patella. The lesions were uniformly characterized by a geographic pattern of bone destruction in the superolateral aspect of the patella. Five lesions were each accompanied by a peripatellar soft tissue mass, four of which contained calcification. It therefore appears that an osteolytic lesion of the superolateral portion of the patella, especially when associated with a peripatellar calcified soft tissue mass, should alert one to the possible diagnosis of gout. Awareness of this possibility may obviate the need for invasive diagnostic procedures. ## Publication types - Research Support, U.S. Gov't, Non-P.H.S. ## MeSH terms - Adult - Aged - Female - Gadolinium DTPA - Gout / diagnosis* - Humans - Knee Joint / diagnostic imaging - Knee Joint / patholo
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