Juvenile intraosseous gout of the calcaneus

Intraosseous Gouty Osteolytic Lesion in Calcaneus

Tophaceous gout often occurs in soft tissues, and gouty invasion to the bone is rare. To date, only one case of isolated intraosseous gouty invasion to the calcaneus has been reported. We report here a rare case of an intraosseous calcaneal gouty cystic lesion treated with curettage and allogenous and autogenous bone graft. Satisfactory function and pain relief were obtained at 12-month follow-up, without any evidence of recurrent disease.

Intraosseous Gouty Tophus in the Talus: A Case Report

Isolated intraosseous gouty invasion is a rare presentation of gout. Although most patients will have a history of gouty arthritis or hyperuricemia, others will have an insidious onset of local pain, tenderness without significant swelling, or inflammation. Surgical debridement is the mainstay of treatment for intraosseous tophus formation.

The broad spectrum of urate crystal deposition: unusual presentations of gouty tophi

OBJECTIVES

Gout is typically described as an inflammatory arthropathy that affects the peripheral joints. Our aim was to describe atypical and rare clinical presentations of gouty tophi to help increase physician awareness and aid in patient care.

METHODS

The relevant English literature of unusual gout manifestations was searched using the keywords gout, toph*, monosodium urate, uric acid, unusual, and rare. Well-described case reports, case series, and review articles were evaluated and included, if relevant, in the literature review.

RESULTS

Review of the literature revealed many unusual manifestations of gouty tophi involving the head and neck, skin, viscera, bones, tendons, ligaments, nerves, and axial skeleton. Transplant recipients, women, and elderly people are particularly susceptible to developing tophi. Furthermore, gout can cause diagnostic dilemmas, as it can be a great mimicker of and can coexist with infection, malignancy, and other connective tissue diseases. Imaging modalities can help detect tophi in atypical locations.

CONCLUSIONS

Tophi can present in unexpected locations, even as the first sign of gout, and vigilance is required when unusual symptoms or signs occur in a patient with gout.