• 제목/요약/키워드: Tophaceous gout

검색결과 8건 처리시간 0.026초

족부 제 1중족 족지 관절에 발생한 만성 결절성 통풍의 수술적 치료 (Surgical Treatment of Chronic Tophaceous Gout in the 1st Metatarso-Phalangeal Joint)

  • 이태훈;남일현;안길영;이영현;이용식;최영득;이희형
    • 대한족부족관절학회지
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    • 제22권4호
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    • pp.156-160
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    • 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.

충돌증후군을 동반한 회전근개에 발생한 결절성 통풍 - 증례 보고 - (Tophaceous Gout in the Rotator Cuff with Impingement Syndrome - A Case Report -)

  • 이우승;윤정로;김영배;강규복;윤호현;이지운
    • 대한관절경학회지
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    • 제17권1호
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    • pp.61-65
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    • 2013
  • 결절성 통풍은 활액, 점액낭, 연골 혹은 기타 연부조직에도 발생할 수 있으며, 회전근개 또는 점액낭 내의 결정성 통풍이 발생한 경우 비-출구 충돌(non-outlet impingement)을 일으킬 수 있다. 그러므로 만성 결절성 통풍을 앓고 있는 환자가 견관절 통증을 호소하는 경우, 회전근개 및 그 주위 조직에 발생한 결절성 통풍에 의한 충돌증후군의 가능성을 고려하여야 한다. 저자들은 50세 남자 환자의 충돌증후군을 동반하는 회전근개에 발생한 결절성 통풍을 경험하였고, 이에 대하여 관절경하 변연 절제술 및 견봉하 감압술을 시행한 결과를 보고하고자 한다.

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봉와직염으로 오인된 아킬레스건 봉합술 후 발생한 아킬레스건 내 결절성 통풍 (Intratendinous Tophaceous Gout Mimicking Cellulitis after Achilles Tendon Repair)

  • 신우진;홍성하;서승표;이승기
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.261-265
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    • 2021
  • 통풍은 임상적으로 흔하게 접하는 질환으로서 특이적인 임상 양상, 혈액 검사 소견, 방사선적 소견으로 대부분의 경우 진단에 어려움이 없다. 그러나 통풍은 때때로 비특이적인 임상 양상을 나타내기도 하며 다른 질환들로 오인될 수 있다. 저자들은 통풍 과거력이 없는 35세 남자 환자에서 아킬레스건 봉합술을 시행한 부위에 11년 후에 처음 발생하여 봉와직염으로 오인된 아킬레스건 내 결절성 통풍 1예를 문헌 고찰과 함께 보고하고자 한다.

붉은귀 거북이(red-eared slider, Trachemys scripta elegans)에서 관절 통풍의 진단 및 치료 증례 (Diagnosis and Management of Articular Gout in a Red-eared Slider (Trachemys Scripta Elegans))

  • 이소영;김주원;박희명
    • 한국임상수의학회지
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    • 제28권4호
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    • pp.449-451
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    • 2011
  • 1.28 kg, 수컷, 13살의 붉은귀 거북이(red-eared slider, Trachemys scripta elegans)가 한 달 간의 식욕 부진, 운동성 감소, 전지 부종 및 발적을 주증으로 내원하였다. 고요산혈증과 함께 방사선 앞발가락과 손목 관절의 비투과성 을 동반한 골융해 소견을 보이는 토피성 통풍(tophaceous gout)이 방사선 검사 상에서 확인되었다. Allopurinol (20 mg/kg, 경구, 하루 한 번)과 u/d (Hill's diet)를 처방하였으며 다른 소염제나 항생제는 투여하지 않았다. 내원 한달 후, 거북이의 임상 증상과 방사선 소견은 호전된 양상을 보여주었다. 약물 반응에 따라, 거북이는 관절 통풍으로 추정 진단되었으며 allopurinol은 거북이의 관절 통풍에 효과적임을 보여주었다.

서양의학의 Gout와 한의학(韓醫學)의 통풍(痛風)의 비교고찰(比較考察) (Compare Gout with Tongp'ung(痛風))

  • 김동욱;김갑성
    • Journal of Acupuncture Research
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    • 제17권4호
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    • pp.100-112
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    • 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).

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Familial Juvenile Hyperuricemic Nephropathy 2례 (Two cases of Familial Juvenile Hyperuricemic Nephropathy)

  • 박진호;최보화;이소영;유은실;박영서
    • Childhood Kidney Diseases
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    • 제1권2호
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    • pp.183-188
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    • 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.

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중족족근관절의 골극으로 인해 발생한 제 2, 3장족지 신전건의 자연적 파열: 증례 보고 (Spontaneous Rupture of the Second and Third Extensor Digitorum Longus Tendons Caused by Osteophyte of the Tarsometatarsal Joint: A Case Report)

  • 박삼국;박철현
    • 대한족부족관절학회지
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    • 제20권1호
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    • pp.46-49
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    • 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.

T2 강조 MR 영상에서 저신호강도를 보이는 윤활막 질환 (Synovial Lesions with Low Signal Intensities on T2-Weighted MR Image)

  • 추혜정;이선주;조길호;서경진;이성문;이영환;이인숙;이경규;김보미
    • Investigative Magnetic Resonance Imaging
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    • 제15권1호
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    • pp.1-10
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    • 2011
  • 색소성 융모결절성 윤활막염, 윤활막 연골종증, 장기간의 류마티스 관절염, 혈우병성 관절병증, 만성 결절성 통풍, 아밀로이드성 관절병증, 결핵성 관절염, 그리고 혈관종 등은 T2 강조 MR 영상에서 저신호강도를 보인다. 혈철소, 요산, 아밀로이드의 윤활막 침착, 증식된 윤활막의 섬유화, 치즈괴사 등이 T2 저신호강도의 병리적 원인으로 알려져 있다. T2 강조영상에서 저신호강도를 보이는 윤활막 질환의 빈도는 낮으므로 이에 대한 숙지는 질환의 정확한 진단에 도움을 줄 것이다.