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Kim, An, Park, and Min: Surgical Treatment of Gouty Tophi in Bilateral Popliteal Cysts
Case Report

Journal of the Korean Orthopaedic Association 2016; 51(2): 178-182.

Published online: 22 April 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.2.178

Surgical Treatment of Gouty Tophi in Bilateral Popliteal Cysts

Ju-Oh Kim, M.D., Ki-Yong An, M.D., Bong-Ju Park, M.D., Woongbae Min, M.D.

Department of Orthopaedic Surgery, Gwangju Bohun Hospital, Gwangju, Korea.

Correspondence to: Ki-Yong An, M.D. Department of Orthopaedic Surgery, Gwangju Bohun Hospital, 99 Cheomdanwolbong-ro, Gwangsan-gu, Gwangju 62284, Korea. TEL: +82-62-602-6162, FAX: +82-62-602-6936, girong@naver.com

Received 27 August 2015       Revised 12 October 2015       Accepted 4 November 2015

Copyright © 2016 by The Korean Orthopaedic Association

(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 often occurs in the first metatarsophalyngeal joint, and also in the ankle joint and posterior foot. Knee joint gouty arthritis is commonly reported, but gouty tophi in bilateral popliteal cysts, such as this case, are rare. We report on a case treated by cystectomy of gouty tophi in bilateral popliteal cysts and review.

Keywords: knee, gout, baker cyst, popliteal cyst, cystectomy

Figures and Tables

Figure 1

(A) Gross finding on both popliteal areas. Approximately 70×60 mm sized firm and round masses are palpated on both popliteal areas. (B) Gross finding on the right 5th finger. Approximately 40×30 mm sized firm and whitish mass on the right 5th proximal interphalangeal joint.

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Figure 2

(A) Preoperative lateral radiograph of the right knee. (B) Preoperative lateral radiograph of the left knee. Soft tissue masses are seen.

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Figure 3

(A) Magnetic resonance imaging (MRI) of the right knee with T2-weighted fat suppression sagittal view shows diffuse calcified synovial thickening in the knee joint, with large calcified mass formation (approximately 6 cm in the long axis) in popliteal fossa. (B) MRI of the left knee T2-weighted. Sagittal view shows diffuse calcified synovial thickening in the knee joint, with large calcified mass formation (approximately 7.5 cm in the long axis) in popliteal fossa.

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Figure 4

Tc-99m hydroxydiphosphonate (HDP) whole body bone scan showed a soft tissue mass with faint increased uptake behind both knee joints. Increased uptake is shown on both knee joints, left ankle joint, right elbow joint and other multiple joints.

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Figure 5

(A) Operative findings. Gross findings of the mass left (B) and right (C). Whitish chalk and toothpaste-like materials were seen in both popliteal cysts.

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Figure 6

Histological images of masses. Deposition of monosodium urate crystals (arrow) were seen (H&E, ×400).

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Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

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