Wilczynski Mark C, Gelberman Richard H, Adams Amelia, Goldfarb Charles A
Washington University Department of Orthopedic Surgery, St. Louis, MO 63110, USA.
J Hand Surg Am. 2009 Feb;34(2):244-50. doi: 10.1016/j.jhsa.2008.10.022. Epub 2009 Jan 9.
We have recently treated several patients with gout of the wrist and scapholunate ligament pathology. The purpose of this investigation was to report the arthroscopic findings of 7 such patients.
We searched our medical records for patients with a diagnosis of gout and nontraumatic wrist pathology. We retrospectively reviewed the clinical, arthroscopic, radiographic, and pathologic findings in 7 patients who failed nonsurgical management and were treated with wrist arthroscopy.
All 7 wrists had diffuse synovitis and crystalline deposits throughout the radiocarpal joint. There were focal crystalline precipitates on the scapholunate and lunotriquetral ligaments but not on the triangular fibrocartilage complex. Scapholunate or lunotriquetral ligament disruption was noted in 6 and 5 wrists, respectively. An early scapholunate advanced collapse pattern of arthritis was present in 5 patients.
Gout affecting the wrist may be associated with crystal deposition on the scapholunate and lunotriquetral ligaments. Ligament incompetence and a scapholunate advanced collapse pattern of wrist arthritis was noted in 6 of our 7 patients.
