Gout

Case contributed by Dr Matthew Lukies

Presentation

Persistent wrist pain. Tenderness over the distal ulna.

Patient Data

Age: 80 years
Gender: Male
X-ray

Multiple well-circumscribed punched-out bony erosions with sclerotic margins, particularly in the ulnar styloid, triquetrum and distal first proximal phalanx.

Juxta-articular soft tissue cloudy densities and swelling distal to the ulna, radial to the second metacarpophalangeal (MCP) joint and radial to the first interphalangeal joint.

CT

Multiple well-circumscribed punched-out bony erosions with sclerotic margins, particularly in the ulnar styloid, triquetrum and distal first proximal phalanx.

Juxta-articular soft tissue cloudy densities and swelling distal to the ulna, radial to the second metacarpophalangeal (MCP) joint and radial to the first interphalangeal joint.

Case Discussion

Findings, in this case, are characteristic of tophaceous gout.

The patient was treated with anti-inflammatory and urate-lowering medications and demonstrated a good response.

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Case information

rID: 53874
Published: 11th Jun 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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