Article

A 73-year-old man presented with nontraumatic debilitating anterior left knee
pain. Magnetic resonance imaging suggested a partial patellar tendon tear.
However, ultrasound imaging revealed multiple small hyperechoic areas with
posterior acoustic shadowing with intermixed hypoechoic fluid within the proximal
patellar tendon, consistent with gouty tophi.
The patient underwent
ultrasound-guided needle barbotage of the tophi. Gout was confirmed by the
presence of uric acid crystals in the aspirate. He had immediate pain relief.
Ultrasound imaging 6 weeks later demonstrated healing of the tendon without tophi
recurrence. At 6-month follow-up, the patient remained asymptomatic. This case
highlights a rare cause of knee pain, promotes diagnostic ultrasound, and
describes a novel treatment technique for intratendinous tophaceous gout.
LEVEL OF EVIDENCE: V.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS