| Giant gouty tophi of the hand and wrist. | |
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MedLine Citation:
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PMID: 22049969 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Gout is an inflammatory-rheumatic disease characterized by an elevated serum urate concentration and recurrent flares, including painful, hot, red, and swollen joints and surrounding tissue. Untreated gout often develops into a chronic disease with tophi and destruction of joint surfaces. Giant tophi are often resistant to medication and change in diet.This article presents a case of a 44-year-old man with giant gouty tophi at his hand and wrist. The last acute gout flare in his left wrist was approximately 3 years prior. For 2 years he had refused adequate nutrition, such as a low-purine diet, and had refused to take any preventive medication. Blood urate level was elevated to 8.7 mg/dL (normal range, 3.4-7.0 mg/dL). In time, the tophi led to a massive limitation of motion and use of especially the left wrist and thumb. Under the condition that the patient changed his diet and took the medication for his underlying disease, we surgically removed the almost skin-perforating tophi. Surgical debulking significantly improved joint function and cosmetic appearance.The best treatment for gouty tophi is prevention by ensuring adequate nutrition, treating the underlying causes, and taking effective medication. In the case of massive limitation of joint motion, skin breakdown with risk of infection, and compression of neurovascular structures, surgical debulking of the tophi should be considered. |
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Authors:
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Falk Mittag; Markus Wuenschel |
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Publication Detail:
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Type: Journal Article Date: 2011-11-09 |
Journal Detail:
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Title: Orthopedics Volume: 34 ISSN: 1938-2367 ISO Abbreviation: Orthopedics Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7806107 Medline TA: Orthopedics Country: United States |
Other Details:
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Languages: eng Pagination: e790-2 Citation Subset: IM |
Copyright Information:
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Copyright 2011, SLACK Incorporated. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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