Fairhurst Rick J, Schwartz Arnold M, Rozmaryn Leo M
The Orthopaedic Center, Rockville, MD, USA.
George Washington University, Washington, DC, USA.
Hand (N Y). 2017 Jan;12(1):NP1-NP5. doi: 10.1177/1558944715627639. Epub 2016 Mar 3.
Given the appreciable prevalence of gout, gout-induced tendon ruptures in the upper extremity are extremely rare. Although these events have been reported only 5 times in the literature, all in patients with a risk factor for or history of gout, they have conspicuously never been diagnosed in the shoulder or elbow. A 45-year-old, right-hand-dominant man with a history of gout presented with pain in his right anterior elbow and weakness in his forearm after a trivial injury. Here, we report the first case of gouty tenosynovitis of the distal biceps tendon insertion complicated by partial rupture, a composite diagnosis supported by both intraoperative and histological observations. In patients who are clinically diagnosed with biceps tendon rupture and have a history of gout, it is important to consider the possibility of a gout-related pathological manifestation causing or simulating tendon rupture.
鉴于痛风的患病率较高，痛风引起的上肢肌腱断裂极为罕见。尽管文献中仅报道过5例此类事件，且均发生在有痛风危险因素或痛风病史的患者中，但明显从未在肩部或肘部诊断出此类病例。一名45岁、惯用右手且有痛风病史的男性，在轻微受伤后出现右肘前部疼痛和前臂无力。在此，我们报告首例肱二头肌远端肌腱附着处痛风性腱鞘炎并发部分断裂的病例，术中及组织学观察均支持这一综合诊断。对于临床诊断为肱二头肌肌腱断裂且有痛风病史的患者，重要的是要考虑痛风相关病理表现导致或模拟肌腱断裂的可能性。
