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Similar Publications

Bone Erosions and Systemic Bone Loss on HR-pQCT in Men With Tophaceous Gout.

Int J Rheum Dis

December 2024

Division of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil.

Aims: Gout, a prevalent inflammatory arthropathy, predominantly affects males and arises from persistent hyperuricemia, resulting in monosodium urate crystal deposition. Hyperuricemia is associated with comorbidities, exacerbating patient morbidity. Conflicting literature exists regarding uric acid's impact on bone mineral density (BMD), with potential proinflammatory effects in gout patients.

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Background: Gout is a disease characterized by hyperuricemia, and resultant deposition of uric acid crystals in tissues. While typically manifested as intraarticular crystals or tophi, gout can also cause pathology at entheses. Gouty deposition within tendinous structures put them at risk for traumatic and degenerative rupture.

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A 74-year-old woman was referred for 18 F-FDG PET/CT for the evaluation of incidental CT finding of expansile destruction of left L4/5 facet joint with associated soft tissue mass concerning for a metastatic deposit. The FDG PET/CT revealed variable abnormally increased FDG activity involving multiple facet joints in all regions of the spine with corresponding expansile "punched-out" lytic lesions with sclerotic rims and overhanging margins on CT, raising the possibility of inflammatory polyarthropathy, including gout, as a differential diagnosis. Dual-energy CT of lumbar spine and CT-guided biopsy and culture of the left L4/5 facet joint demonstrated the presence of urate crystal deposition with no evidence of malignancy or infection, confirming the diagnosis of multilevel tophaceous gout of the spine.

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Gout is a common, chronic inflammatory arthritis that oftentimes accompanies an initial acute and painful attack characterized by intense pain and swelling. Although it may present in different sites such as the ankles, wrists, knees, elbows, and fingers, the lower extremities are the most common site of involvement. The pathophysiology of gout is complex, but typically, the deposition of monosodium urate crystals within the joint space and the subsequent acute inflammatory response play an important role.

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A Case of Tophaceous Pseudogout with Destruction of the Skull Base at the Temporomandibular Joint.

Indian J Otolaryngol Head Neck Surg

June 2023

Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan.

We report a case of tophaceous pseudogout that occurred in the temporomandibular joint (TMJ) and presented with skull base destruction. The patient was a 73-year-old woman, who complained of an obstructed ear sensation in December 2021. The otolaryngological examination was unremarkeable, and a computed tomography scan revealed a calcified lesion in the left TMJ.

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