Hng Joel, Manchella Sankar, Lekgabe Ernest
Department of Oral & Maxillofacial Surgery, The Royal Melbourne Hospital, Parkville, VIC, Australia.
Department of Radiology, The Royal Melbourne Hospital, Parkville, VIC, Australia.
BJR Case Rep. 2022 Oct 5;9(1):20220046. doi: 10.1259/bjrcr.20220046. eCollection 2023 Feb.
Gout is a disease characterised by abnormal deposition of monosodium urate crystals, typically affecting the extremities. This report describes a rare case of gout affecting the left temporomandibular joint with erosion of the skull base. A diagnosis of gout was suspected based on CT and MRI and confirmed with CT-guided biopsy. The temporomandibular joint is an uncommon location for a first presentation of gout, with very few cases documented and only three cases of skull base involvement reported in the English literature previously. Given its radiological appearance, it can easily be misdiagnosed as other erosive arthropathies or malignancy. Our paper highlights an unusual location for the first and only manifestation of gout and offers some diagnostic and treatment ideas that may help clinicians to identify and manage this disease.
痛风是一种以尿酸钠晶体异常沉积为特征的疾病，通常累及四肢。本报告描述了一例罕见的痛风病例，累及左颞下颌关节并伴有颅底侵蚀。根据CT和MRI怀疑为痛风，并经CT引导下活检确诊。颞下颌关节是痛风首次发作的罕见部位，文献记载的病例很少，此前英文文献中仅报道过3例累及颅底的病例。鉴于其影像学表现，很容易被误诊为其他侵蚀性关节病或恶性肿瘤。我们的论文强调了痛风首次及唯一表现的不寻常部位，并提供了一些诊断和治疗思路，可能有助于临床医生识别和管理这种疾病。
