An Intratendinous Tophaceous Gout Mistaken for Cellulitis in the Patellar Tendon

Se-Hyuk Im; Bo-Kyu Yang; Seok-Woo Nam; Hyun-Seok Chung; Seung-Rim Yi; Young-Joon Ahn; Seong-Wan Kim; Ye-Hyun Lee

doi:10.4055/jkoa.2015.50.4.337

Journal List > J Korean Orthop Assoc > v.50(4) > 1013390

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Im, Yang, Nam, Chung, Yi, Ahn, Kim, and Lee: An Intratendinous Tophaceous Gout Mistaken for Cellulitis in the Patellar Tendon

Case Report

Journal of the Korean Orthopaedic Association 2015; 50(4): 337-341.

Published online: 24 August 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.4.337

An Intratendinous Tophaceous Gout Mistaken for Cellulitis in the Patellar Tendon

Se-Hyuk Im, M.D., Bo-Kyu Yang, M.D., Seok-Woo Nam, M.D., Hyun-Seok Chung, M.D., Seung-Rim Yi, M.D., Young-Joon Ahn, M.D., Seong-Wan Kim, M.D., Ye-Hyun Lee, M.D.

Department of Orthopaedic Surgery, National Police Hospital, Seoul, Korea.

Correspondence to: Bo-Kyu Yang, M.D. Department of Orthopaedic Surgery, National Police Hospital, 123 Songi-ro, Songpa-gu, Seoul 05715, Korea. TEL: +82-2-449-2120, FAX: +82-2-3400-1247, jdoc3846@google.com

Received 29 August 2014 Revised 28 October 2014 Accepted 22 December 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gout is characterized by recurrent attacks of arthralgia, and deposition of monosodium urate crystals in and around the joints of the extremities and soft tissues. Monosodium urate crystals are observed most frequently at the 1st metatarsophalangeal joint and usually presented in the ankle and wrist joint. However, no case of an intratendinous tophus in the patellar tendon has been reported in Korean literature. In this report, we found monosodium urate crystals in the patellar tendon on magnetic resonance imaging images and intratendinous tophus were visible to the naked eye by excision. We reported on the case of a patient who experienced an unusual intratendinous tophus in the patellar tendon.

Keywords: patellar tendon, gout

Figures and Tables

Figure 1

Knee joint anterioposterior view (A) and knee joint lateral view (B) shows no definite findings.

Figure 2

(A) T1-weighted spiral sagittal enhancement magnetic resonance imaging (MRI) shows edematous change from the prepatellar area to the pretibial area and rim enhancement at the infrapatellar fat pad area. (B) T1-weighted axial enhancement MRI shows fluid collection and peripheral rim enhancement in the middle of the patellar and retro-patellar tendon area.

Figure 3

(A) T2-weighted sagittal magnetic resonance imaging (MRI) shows intratendinous fluid collection along the patellar tendon and infrapatellar fat pad area. (B) T2-weighted axial MRI shows fluid collection in the middle of the patellar and retro-patellar tendon area.

Figure 4

(A) Intraoperative photograph shows white caseous materials. (B) Below the white caseous material, yellowish fluid collection was found.

Figure 5

Chalky white mass was found after dissection.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose

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