• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.61-65
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• 2013

Tophaceous gout, which is usually presented in the synovial fluid, bursal lining, cartilage or other soft tissues, may cause a nonoutlet impingement in the rotator cuff and bursa. In chronic tophaceous gout patient with the shoulder pain, a surgeon should consider the possibility of the tophaceous gout of the rotator cuff. We report a surgical experience of a 50-year-old man with tophaceous gout of the rotator cuff causing impingement syndrome. The patient was treated successfully with arthroscopic debridement and subacromial decompression.

• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.261-265
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• 2021

A diagnosis of gout is often straightforward because gout has well known clinical presentations, laboratory analyses, and radiologic features. On the other hand, gout can mimic other diseases by showing a range of atypical clinical manifestations. This paper reports a 35-year-old male with no prior history of gout who developed tophaceous gout at his previously repaired Achilles tendon 11 years after surgery. He was initially misdiagnosed with cellulitis because of his atypical clinical features. This case is presented with a review of the relevant literature.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.78-83
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• 2019

Tophi is one of the clinical manifestations of gout. On the other hand, it does not draw the patient's attention when it is asymptomatic, which leads to delayed management. The current case is a typical example of delayed diagnosis and management. The authors' preferred management of tophi was medical not surgical, even though the hitherto therapeutic issue has been conservative versus surgical. The authors chose conservative treatment in the osteolytic lesion resulting from huge tophi in the patella, and the report the results of 6 years follow-up.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.155-158
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• 1999

Recently arthroscopic procedure was introduced into an effective method when chronic gouty arthritis associated with acute inflammation is unresponsive to conservative treatment. The purpose of this study is to cvaluate the efficacy of tophi excision during this procedure. We tried to excise tophi which were known as one of causative materials of acute inflammation as much as possible. We report one case of chronic tophaceous gouty arthritis of the right knee which was satisfactorily treated without recurrence during more than one year after this arthroscopic procedure.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.1-10
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• 2011

Pigmented villonodular synovitis, synovial chondromatosis, long-standing rheumatoid arthritis, hemophilic arthropathy, chronic tophaceous gout, amyloid arthropathy, tuberculous arthritis, and hemangioma are the synovial diseases showing low signal intensity on T2-weighted image. Synovial deposition of hemosiderin, urate, and amyloid and fibrosis or caseous necrosis of hypertrophied synovium are known as the pathologic causes of T2 signal intensity. Because of the low incidence of the synovial lesions showing T2 low signal intensity, recognition of these diseases would be helpful for the exact diagnosis.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.