Tarsal Tunnel Syndrome Associated with Gout Tophi: A Case Report

Sam Guk Park; Chul Hyun Park; Hyo Se Ahn

doi:10.14193/jkfas.2016.20.2.84

Journal List > J Korean Foot Ankle Soc > v.20(2) > 1043417

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Park, Park, and Ahn: Tarsal Tunnel Syndrome Associated with Gout Tophi: A Case Report

Case Report

J Korean Ophthalmol Soc 2016;20(2):84-87.

Published online: 19 June 2016

DOI: https://doi.org/10.14193/jkfas.2016.20.2.84

Tarsal Tunnel Syndrome Associated with Gout Tophi: A Case Report

Sam Guk Park^a, Chul Hyun Park^*, Hyo Se Ahn^*

Department of Orthopedic Surgery, Gyeongsan Joongang Hospital, Gyeongsan, Korea

^*Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea

Corresponding Author: Chul Hyun Park Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea Tel: 82-53-620-3640, Fax: 82-53-628-4020, E-mail: chpark77@naver.com

^a Current affiliation: Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea

Received 3 January 201619 April 2016 Accepted 20 April 2016

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

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or its branches in the fibro-osseous tunnel beneath the flexor retinaculum. This pathology is associated with multiple etiologies, including trauma, space-occupying lesions, and impaired biomechanics. We report a case of tarsal tunnel syndrome associated with gout tophi in a patient with untreated gout along with a review of the relevant literature on tarsal tunnel syndrome.

Keywords: Tarsal tunnel syndrome, Gout, Tophi

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Figure 1.

Axial computed tomograph shows osteolytic changes with subcortical cysts and multiple calcifications in the talar body (A) and in the first and second tarsometatarsal joints (B).

Figure 2.

Coronal magnetic resonance images show an ill-defined mass in the talar body with low signal intensity on T1-weighted imaging (A) and of heterogeneous signal intensity on T2-weighted imaging (B).

Figure 3.

(A, B) Intraoperative photo shows a gouty tophus compressing the medial plantar nerve. (C) The excised mass was composed of a yellowish tissue.

Figure 4.

Histopathologic findings with H&E stain (A: ×100, B: ×200) show the presence of crystal deposits surrounded by a scalloping of palisaded histiocytes and multinucleated giant cells (arrows) containing an amorphous-appearing pale to pink deposits in the center (arrowheads).

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