Gouty involvement of the patella and extensor mechanism of the knee mimicking aggressive neoplasm. A case series.

MedStar author(s):
Citation: Skeletal Radiology. 47(6):865-869, 2018 Jun.PMID: 29332201Institution: MedStar Franklin Square Medical Center | MedStar Washington Hospital CenterDepartment: Orthopaedic Oncology, National Center for Bone and Soft Tissue Tumors | Orthopaedic Onology | RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Gout/dg [Diagnostic Imaging] | *Knee Joint/dg [Diagnostic Imaging] | *Magnetic Resonance Imaging | *Patella/dg [Diagnostic Imaging] | *Tomography, X-Ray Computed | Aged | Bone Neoplasms | Diagnosis, Differential | Gout/pa [Pathology] | Gout/su [Surgery] | Humans | Knee Joint/pa [Pathology] | Knee Joint/su [Surgery] | Male | Middle Aged | Patella/pa [Pathology] | Patella/su [Surgery] | Sensitivity and SpecificityYear: 2018Local holdings: Available online from MWHC library: 1997 - presentISSN:
  • 0364-2348
Name of journal: Skeletal radiologyAbstract: Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease. Soft tissue deposits and tendon involvement are also known manifestations of gout, but can present with indeterminate and alarming findings on imaging. We present three cases of tophaceous gout mimicking aggressive neoplasms in the extensor mechanism of the knee. All cases presented as extensor tendon masses eroding into the patella, with imaging findings initially concerning for primary musculoskeletal malignancy.All authors: Aboulafia A, Jelinek J, Kester C, Wallace MTFiscal year: FY2018Digital Object Identifier: ORCID: Date added to catalog: 2018-01-22
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Journal Article MedStar Authors Catalog Article 29332201 Available 29332201

Available online from MWHC library: 1997 - present

Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease. Soft tissue deposits and tendon involvement are also known manifestations of gout, but can present with indeterminate and alarming findings on imaging. We present three cases of tophaceous gout mimicking aggressive neoplasms in the extensor mechanism of the knee. All cases presented as extensor tendon masses eroding into the patella, with imaging findings initially concerning for primary musculoskeletal malignancy.

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