Vetter S Y, Simon R, von Recum J, Wentzensen A, Spiethoff A, Frank C B
BG Trauma Center Ludwigshafen, Department for Trauma- and Reconstructive Surgery, Ludwigshafen, University of Heidelberg, Germany.
Foot Ankle Surg. 2008;14(4):229-32. doi: 10.1016/j.fas.2008.03.002. Epub 2008 Jun 10.
This case demonstrates a yet unreported clinical entity of bilateral tophaceous cystic lesions of the tibiotalar joints of an 37-year-old white male who presents with moderate painful swelling in both upper ankle joints for 2 years. Radiodiagnostic studies show cystic lesions in both upper ankle joints and the right talus considering neoplastic processes in the differential diagnosis. The incisional biopsy reveals chalk-like material of the intraosseous lesions which was pathognomonic for tophaceous gout. Antihyperuricemic medication led to a stagnation of growth of the lesions without a sign of osseous remodeling. However, due to limitation of discomfort, personal preferences and a lack of surgical options conservative treatment was maintained.
该病例展示了一名37岁白人男性双侧胫距关节痛风石性囊性病变这一尚未报道的临床实体，该患者双侧上踝关节中度疼痛肿胀2年。放射诊断研究显示双侧上踝关节及右距骨有囊性病变，鉴别诊断时考虑肿瘤性病变。切开活检显示骨内病变有白垩样物质，这是痛风石性痛风的特征性表现。降尿酸药物治疗使病变生长停滞，无骨质重塑迹象。然而，由于不适受限、个人偏好及缺乏手术选择，仍维持保守治疗。
