Tophaceous Gout of the Wrist Mimicking Tumorous Mass Causing Digital Flexion Contracture: Case Report

痛風石模擬腕部腫瘤引發手指關節彎曲攣縮：個案報告

黃錦前(Chin-Chean Wong)；何為斌(Wei-Pin Ho)

gout ； tophaceous ； flexion contracture

Journal of Orthopaedic Surgery Taiwan

27卷2期（2010 / 06 / 01）

87 - 90

英文

Purpose: In this article, we highlight the unusual presentation of the gouty tophus that mimicking a tumorous mass of the wrist that causing digital flexion contracture of hand. We aim to emphasize the importance of considering this disease entity in the differential diagnosis of a wrist mass in a patient with digital flexion contracture of hand. Case report [Materials & Methods]: We reported a case of isolated gouty involvement of the flexor tendon of the wrist which was mimicking a tumorous mass that causing digital flexion contracture of the hand. In this case, the patient is a young-aged male with no known past history of gouty arthritis who presenting to clinic with a slowly-growing mass at his left wrist. His left middle finger was fixed in complete flexion position. Magnetic resonance (MR) imaging showed a well-defined space-occupying lesion with heterogenous intensity which was located at volar aspect of wrist. Results: Surgical exploration was performed and a tophaceous mass was found infiltrating the flexor tendon of wrist obstructing the passage of tendon through the carpal tunnel. The pathology report further confirmed the diagnosis of tophaceous gout. Conclusions: Tophaceous gout involving the wrist is an unusual condition, but is possible in chronic cases with long history of hyperuricemia. This unusual case raises awareness of a wrist mass causing digital flexion contracture as one manifestation of gout.