Gout - both knees (MRI)

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Bilateral knee pain and effusion. ? Meniscal tear

Patient Data

Age: 65 years
Gender: Male
x-ray

A small knee joint effusion and apparent thickening of the quadriceps tendon. Subcutaneous edema adjacent to the lateral joint line. Arterial calcifications. 

Right knee

mri

Peri-ligamentous and peri-tendinous intermediate PD signal material seen in association with the popliteus tendon, the cruciate ligaments, deep proximal aspect of the MCL and lateral superficial aspect of the quadriceps tendon. This is typical of periarticular gout. A non-displaced horizontal tear of the medial meniscal posterior horn is also identified extending to the tibial surface. Small to moderate knee joint effusion. 

Left knee

mri

The left knee shows a similar appearance to the right knee but without involvement of the cruciates or quadriceps tendon. There is extensive deposition of material around the popliteus tendon and medial collateral ligament. 

Case Discussion

A case of extensive bilateral knee periarticular gout with characteristic peri-tendinous and peri-ligamentous deposition of urate.    

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