• Journal of Korean Foot and Ankle Society
• /
• v.22 no.4
• /
• pp.156-160
• /
• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.

• Journal of the Korean Arthroscopy Society
• /
• v.17 no.1
• /
• pp.61-65
• /
• 2013

Tophaceous gout, which is usually presented in the synovial fluid, bursal lining, cartilage or other soft tissues, may cause a nonoutlet impingement in the rotator cuff and bursa. In chronic tophaceous gout patient with the shoulder pain, a surgeon should consider the possibility of the tophaceous gout of the rotator cuff. We report a surgical experience of a 50-year-old man with tophaceous gout of the rotator cuff causing impingement syndrome. The patient was treated successfully with arthroscopic debridement and subacromial decompression.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.3
• /
• pp.261-265
• /
• 2021

A diagnosis of gout is often straightforward because gout has well known clinical presentations, laboratory analyses, and radiologic features. On the other hand, gout can mimic other diseases by showing a range of atypical clinical manifestations. This paper reports a 35-year-old male with no prior history of gout who developed tophaceous gout at his previously repaired Achilles tendon 11 years after surgery. He was initially misdiagnosed with cellulitis because of his atypical clinical features. This case is presented with a review of the relevant literature.

• Journal of Veterinary Clinics
• /
• v.28 no.4
• /
• pp.449-451
• /
• 2011

An 1.28 kg, male, thirteen years of age, red-eared slider (Trachemys scripta elegans) was presented with one month history of anorexia, decreased mobility, and swelling and erythema of forelimbs. Hyperuricemia and tophaceous gout such as osteolysis at the digit, carpal and metacarpal bones with radiopaque densities around the lesion were detected. Allopurinol (20 mg/kg, PO, once a day) and u/d (Hill's diet) were selected for treatment and other antibiotics or anti-inflammatory drugs were not administered. One month after initial presentation, clinical signs and radiographic findings were improved. According to the medical response, the turtle was presumptively diagnosed as articular gout and allopurinol revealed effective response to the articular gout in turtles.

• Journal of Acupuncture Research
• /
• v.17 no.4
• /
• pp.100-112
• /
• 2000

Compare western medicine report and books which refer to Gout with Oriental medicine books which refer to Tongp'ung(痛風). The results of studying about Gout and Tongp'ung(痛風) were summarized as follows. l. Dangyesimbub(丹溪心法) was printed in 1481 and also the first book which referred to Tongp'ung(痛風). 2. Donwonsipjonguiso(東垣十種醫書) was printed in 1592 and also Tongp'ung(痛風) was recorded like gout especially in cause of disease. 3. Ancient times, Affection by exopathogen and six kinds of natural factors were persisted the cause of Tongpung(痛風), later generation drink, diet and labor were persisted. 4. In Beunjungrok(辨證錄) and susyebowon(壽世保元), there were similar expressions about gout, for examples interval phase and chornic tophaceous. 5. In Uihakjongjon(醫學正傳) and Manbeunghoechun(萬病回春) insisted that gout patients had to control their food especially meat, fish snd drink. 6. According to the cause(Pung(風), Han(寒), Sub(濕)), doctor classified Bi(痺) first was Hangbi(行痺), second was Tongbi(痛痺) and last was Chakbi(着痺). 7. Doctors thought that Tongp'ung(痛風,) was not Hangbi(行痺) and Chakbi(着痺) but it was Tongbi (痛痺). Especially in pain, they thought it was similar to Bakhoyeukjolp'ung(白虎歷節風).

• Childhood Kidney Diseases
• /
• v.1 no.2
• /
• pp.183-188
• /
• 1997

Familial juvenile hyperuricemic nephropathy is an autosomal dominant disease characterized by progressive renal disease and hyperuricemia or gout, affecting young people of either sex equally. There are two biochemical markers of this disorder. The first is hyperuricemia disproportionate to the degree of renal dysfunction; the second is a grossly reduced clearance of uric acid relative to creatinine, dispropotionate to age, sex and degree of renal failure. We experienced 2 family members with hyperuricemia. One family member, a 13-year-old girl who had suffered from tophaceous gout and chronic renal failure. Her younger brother also had hyperuricemia and moderately reduced renal function. Their urinary excretion fractions of uric acid($FE_{uric\;acid}$) were reduced and renal biopsy specimens showed interstitial fibrosis with tubular atrophy and interstitial urate crystal deposition. We have treated these two patients with allopurinol but we have done renal transplantation because she progressed to end stage renal disease at 16 year old age.

• Journal of Korean Foot and Ankle Society
• /
• v.20 no.1
• /
• pp.46-49
• /
• 2016

Spontaneous rupture of the extensor tendon has been reported in association with predisposing inflammatory conditions including rheumatoid arthritis, diabetes, trauma, tophaceous gout, and steroid injection. The authors experienced a case of spontaneous rupture of the extensor digitorum longus tendons caused by an osteophyte of the tarsometatarsal joint in a patient with rheumatoid arthritis. The authors stress that aggressive treatment including surgery could be considered for prevention of spontaneous tendon rupture in a patient with predisposing conditions despite an asymptomatic spur.

• Investigative Magnetic Resonance Imaging
• /
• v.15 no.1
• /
• pp.1-10
• /
• 2011

Pigmented villonodular synovitis, synovial chondromatosis, long-standing rheumatoid arthritis, hemophilic arthropathy, chronic tophaceous gout, amyloid arthropathy, tuberculous arthritis, and hemangioma are the synovial diseases showing low signal intensity on T2-weighted image. Synovial deposition of hemosiderin, urate, and amyloid and fibrosis or caseous necrosis of hypertrophied synovium are known as the pathologic causes of T2 signal intensity. Because of the low incidence of the synovial lesions showing T2 low signal intensity, recognition of these diseases would be helpful for the exact diagnosis.