Tobimatsu Haruki, Nakayama Masanori, Sakuma Yu, Imamura Hitoshi, Yano Koichiro, Itagaki Hiroko, Ikari Katsunori
Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
Department of Surgical Pathology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan.
Case Rep Orthop. 2017;2017:7201312. doi: 10.1155/2017/7201312. Epub 2017 Dec 20.
A 45-year-old man presented with painless subcutaneous masses bilaterally on his hands and loss of motion or contracture of the fingers. Initially, drug therapy to reduce the serum uric acid was administered and was expected to reduce the tophi. However, during observation at the clinic, spontaneous rupture of an extensor tendon occurred, and surgical repair of the tendon and resection of the masses were performed. Surgical exploration of the right hand showed hypertrophic white-colored crystal deposits that both surrounded and invaded the extensor digitorum communis of the index finger, which was ruptured. Histopathologic examination of the specimen demonstrated findings consistent with gouty tophi. Tophaceous gout can induce a rupture of tendons during clinical observation, and surgical resection of the tophi might be needed to prevent ruptures.
一名45岁男性双手出现双侧无痛性皮下肿块，手指活动受限或挛缩。最初，给予降低血清尿酸的药物治疗，期望减少痛风石。然而，在门诊观察期间，一条伸肌腱自发断裂，遂进行了肌腱手术修复和肿块切除术。右手手术探查显示，肥厚的白色晶体沉积物围绕并侵入食指指总伸肌，该伸肌已断裂。标本的组织病理学检查结果符合痛风石表现。痛风石性痛风在临床观察期间可导致肌腱断裂，可能需要手术切除痛风石以预防断裂。
