Journal List > J Korean Foot Ankle Soc > v.22(3) > 1101130

Oh, Choi, Ha, Park, Kim, and Yoon: Chronic Multiple Gouty Arthritis Diagnosed during Anti-Tuberculosis Treatment of Recurrent Tuberculous Arthritis: A Case Report

Abstract

Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.

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Figure 1.
Bone scan shows hot uptake at right elbow, wrist, hand, foot, and lumbar area (black arrows). IV: intravenous.
jkfas-22-116f1.tif
Figure 2.
(A) Gross photo shows swelling on right hallux. (B, C) Plain radiograph shows soft tissue swelling, bony erosion, osteopenia and mild subluxation on 1st metatarsal and phalanx.
jkfas-22-116f2.tif
Figure 3.
Sagittal T1 (A) fat suppression and T2 (B) weighted magnetic resonance imaging demonstrates a low to intermediate signal intensity mass around 1st metatarsophalangeal joint.
jkfas-22-116f3.tif
Figure 4.
Specimen shows chalky whitishy deposit.
jkfas-22-116f4.tif
Figure 5.
Amorphous tophaceous deposit surrounded by multinucleated giant cells and macrophage was noted (H&E stain, ×100).
jkfas-22-116f5.tif
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