Lagoutaris Emmanuel D, Adams Heiko B, DiDomenico Lawrence A, Rothenberg Ralph J
PGY III, Podiatric Surgical Resident, Forum Health Western Reserve Care System, Youngstown, OH, USA.
J Foot Ankle Surg. 2005 May-Jun;44(3):222-4. doi: 10.1053/j.jfas.2005.02.008.
The authors report a case of longitudinal tendon tears of the peroneus longus and brevis in the presence of tophaceous gouty infiltration. There are a limited number of reports discussing similar processes affecting various tendons throughout the body. There has been 1 prior case of peroneal tendon involvement affecting only the peroneus brevis. A 35-year-old man presented with a 4-year history of left-sided lateral ankle pain, redness, and swelling. The patient described the "attacks" as occurring off and on, with a recent increase in frequency. The symptoms were relieved with indomethacin, colchicine, and narcotic analgesics. Upon clinical evaluation, there was a cavus foot type with moderate calcaneal varus. Peroneal subluxation was elicited with resisted eversion. An MRI evaluation revealed longitudinal tears of both peroneal tendons. During surgical repair, a chalky-white substance resembling gouty tophi was present within both tendon tears. The tendons were remodeled and repaired. The patient had an uneventful postoperative course with nearly completed resolution of his symptoms at 1-year follow-up. The patient was referred to his primary care physician for further evaluation and long-term control of elevated uric acid levels.
作者报告了1例伴有痛风石浸润的腓骨长肌和腓骨短肌纵向肌腱撕裂病例。讨论影响全身各种肌腱的类似过程的报告数量有限。此前有1例腓骨肌腱受累病例，仅累及腓骨短肌。一名35岁男性，有4年左侧外踝疼痛、红肿病史。患者称“发作”断断续续，近期发作频率增加。吲哚美辛、秋水仙碱和麻醉性镇痛药可缓解症状。临床评估时，发现为高弓足类型，伴有中度跟骨内翻。抗阻外翻时引出腓骨半脱位。MRI评估显示两条腓骨肌腱均有纵向撕裂。手术修复时，在两条肌腱撕裂处均发现了类似痛风石的灰白色物质。对肌腱进行了重塑和修复。患者术后恢复顺利，1年随访时症状几乎完全缓解。患者被转介给其初级保健医生，以进一步评估和长期控制尿酸水平升高。
