Unusual case of pseudotumoral hip injury due to gout: case report
DOI:
https://doi.org/10.5281/zenodo.10064752Keywords:
Hip, Gout, ArthritisAbstract
Background: Gout is known as arthropathy due to the de[1]posit of monosodium urate crystals; This pathology comprises a set of clinical and radiographic tests in the context of the intra-articular presence of said crystals. It is a chronic disease associated with other comorbidities such as arterial hypertension, osteoarthritis, diabetes mellitus, etc. The case of a patient with gouty arthritis with consequent hip lesion with a pseudotumoral appearance difficult to diagnose is presented, in order to highlight the importance of this, as well as the appropriate follow-up and treatment for this chronic pathology.
Clinic case: A 51-year-old male patient, with a history of hip osteoarthritis and gout. The symptoms and signs were pain in the right hip with an 8/10 on an analogue pain scale, associated with functional limitation characterized by reduced range of motion and impossibility of standing. Imaging studies are carried out which are suggestive of a tumor lesion at the proximal femur with malignant characteristics, for which a biopsy and subsequent histopathological diagnosis of gouty tophi is performed.
Conclusions: Gout is a prevalent disease in the adult population, however, its infrequent joint location can result in a difficult diagnosis, so it is necessary not to rule out this entity and to carry out specific studies for its identification.
Downloads
References
Weaver JS, Vina ER, Munk PL, et al. Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging. J Clin Med. 2021;11(1):166. doi: 10.3390/jcm11010166.
Sivera F, Andres M, Dalbeth N. A glance into the future of gout. Ther Adv Musculoskelet Dis. 2022;14:1759720X221114098. doi: 10.1177/1759720X221114098.
Schlienger JL. L’histoire des tourments de la podagre (goutte). Épidémiologie, coûts et organisation des soins. 2014;8(2):230- 4. doi: 10.1016/S1957-2557(14)70747-3.
Ludeña-Suárez MC, Marín-Ferrín RE, Anchundia-Cunalata EF, et al. Diagnóstico, tratamiento y prevención de la gota. CCM. 2020; 24(1):1-29. 5. Velasco-Bustamante JA, Velasco-Bustamante DL, Baquero-Vallejo GA, et al. Monoartritis aguda. Urgencia en la atención reumatológica. Rev Cuba Reumatol. 2019; 21(2):e92.
Sidari A, Hill E. Diagnosis and Treatment of Gout and Pseudogout for Everyday Practice. Prim Care. 2018;45(2):213-36. doi: 10.1016/j.pop.2018.02.004.
Light J, Wellman LL, Conran RM. Educational Case: Gout. Acad Pathol. 2023;10(1):100065. doi: 10.1016/j.acpath.2022. 100065.
Zhao J, Wei K, Jiang P, et al. Inflammatory Response to Regulated Cell Death in Gout and Its Functional Implications. Front Inmmunol. 2022;13:888306. doi: 10.3389/fimmu.2022.888306.
Dalbeth N, Choi HK, Joosten LAB, et al. Gout. Nat Rev Dis Primers. 2019;5(1):69-85. doi: 10.1038/s41572-019-0115-y.
Dalbeth N, Gosling AL, Gaffo A, et al. Gout. Lancet. 2021; 397 (10287):1843-55. doi: 10.1016/S0140-6736(21) 00569-9.
Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective – A review. J Adv Res. 2017;8(5):495-511. doi: 10.1016/j.jare.2017.04.008.
Ahmad MI, Masood S, Furlanetto DM, et al. Urate Crystals; Beyond Joints. Front Med (Lausanne). 2021;8(1):649-505. doi: 10.3389/fmed.2021.649505.
FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res (Hoboken). 2020;72(6):744-60. doi: 10.1002/acr.24180.
Huang Y, Huang J, Luo C, et al. Treatment of atypical gouty arthritis of the hip using total hip arthroplasty: A case report. Medicine (Baltimore). 2020;99(44):e23027. doi: 10.1097/MD. 0000000000023027.
Tolin MC, Navarra SV. Severe hip and knee pain in a man with chronic tophaceous gout. Int J Rheum Dis. 2009;12(1):57-60. doi: 10.1111/j.1756-185X.2009.01385.x.
Dos Santos VM, Passini-Soares VV, de Faria PS, et al. A 52-year-old man with gouty arthritis and erosive lesión in the hip. Rom J Morphol Embryol. 2017;58(2):557-60.
Di Matteo A, Filippucci E, Cipolletta E, et al. Ultrasound and clinical features of hip involvement in patients with gout. Joint Bone Spine. 2019;86(5):633-6. doi: 10.1016/j.jbspin.2019. 01.027.
Deng SH, Dang WT, Liu J, et al. Differential diagnosis of acute and chronic gouty arthritis bymultijoint ultrasound. Ultrasound Med Biol. 2021;47(10):2853-9. doi: 10.1016/j. ultrasmedbio.2021.05.005.
Poratt D, Rome K. Surgical Management of Gout in the Foot and Ankle: A Systematic Review. J Am Podiatr Med Assoc. 2016;106(3):182-8. doi: 10.7547/14-128.
Zhang T, Yang F, Li J, et al. Gout of the axial joint - A patiente level systemic review. Semin Arthritis Rheum. 2019;48(4): 649-57. doi: 10.1016/j.semarthrit.2018.04.006.
Wu J, Zhang YP, Qu Y, et al. Efficacy of uric acid-lowering therapy on hypercholesterolemia and hypertriglyceridemia in gouty patients. Int J Rheum Dis. 2019;22(8):1445-51. doi: 10.1111/1756-185X.13652.
McKenzie BJ, Wechalekar MD, Johnston RV, et al. Colchicine for acute gout. Cochrane Database Syst Rev. 2021;8(8): CD006190. doi: 10.1002/14651858.CD006190.pub3.
Keller SF, Mandell BF. Management and Cure of Gouty Arthritis. Med Clin North Am. 2021;105(2):297-310. doi: 10.1016/j. mcna.2020.09.013.
Pillinger MH, Mandell BF. Therapeutic approaches in the treatment of gout. Semin Arthritis Rheum. 2020;50 Suppl 3:S24-30. doi: 10.1016/j.semarthrit.2020.04.010.
Sriranganathan MK, Vinik O, Pardo J, et al. Interventions for tophi in gout. Cochrane Database Syst Rev. 2021;8(8):CD010069. doi: 10.1002/14651858.CD010069.pub3.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Revista Médica del Instituto Mexicano del Seguro Social
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.
