Akram Qasim, Hughes Michael, Muir Lindsay
Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK.
Salford Royal Foundation Trust, Salford, Manchester, UK.
BMJ Case Rep. 2016 Jun 29;2016:bcr2015213601. doi: 10.1136/bcr-2015-213601.
Flexor tenosynovitis of the hand is often caused by trauma or infection. Gouty tenosynovitis is an uncommon presentation of the condition and is usually misdiagnosed as infection with the patient undergoing surgery. The coexistence of infection and gout causing flexor tenosynovitis has never been described before in the literature; we report the first ever case and emphasise the importance of its awareness for optimal treatment. A 54-year-old man was initially diagnosed and treated as having infective flexor tenosynovitis and, later, due to a lack of improvement in his symptoms, was discovered to also have gout. We review the literature and suggest management strategy for use in daily clinical practice, including an algorithm, for this presentation.
手部屈指肌腱腱鞘炎常由创伤或感染引起。痛风性腱鞘炎是该病症的一种罕见表现，通常会被误诊为感染，患者需接受手术治疗。感染与痛风并存导致屈指肌腱腱鞘炎的情况此前在文献中从未有过描述；我们报告了首例此类病例，并强调认识到这一情况对于优化治疗的重要性。一名54岁男性最初被诊断并当作感染性屈指肌腱腱鞘炎进行治疗，后来由于症状没有改善，发现他还患有痛风。我们回顾了相关文献，并针对这种情况提出了日常临床实践中可采用的管理策略，包括一个算法。
