Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review
Background: Tophaceous gout, when manifested as a posterior cruciate ligament (PCL) mass within a joint, is uncommon. Differentiating it from other intraarticular pathologies, notably tenosynovial giant cell tumors (TGCT), previously known as pigmented villonodular synovitis (PVNS), proves challengi...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Journal of Orthopaedic Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773157X23001479 |
| _version_ | 1797447991815045120 |
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| author | Osama Alzobi Ayyoub Mohammed Ashraf Hantouly Ghislain Aminake Theodorakys Marín Bashir Zikria |
| author_facet | Osama Alzobi Ayyoub Mohammed Ashraf Hantouly Ghislain Aminake Theodorakys Marín Bashir Zikria |
| author_sort | Osama Alzobi |
| collection | DOAJ |
| description | Background: Tophaceous gout, when manifested as a posterior cruciate ligament (PCL) mass within a joint, is uncommon. Differentiating it from other intraarticular pathologies, notably tenosynovial giant cell tumors (TGCT), previously known as pigmented villonodular synovitis (PVNS), proves challenging. This difficulty arises primarily from the resemblances in their presentation on standard radiological tools such as MRI. Notably, the lesion appearance in tophaceous gout closely aligns with that of TGCT. Case report: We present a case of intraarticular tophaceous gout in a 35-year-old male localized in the posterior chamber of the left knee, particularly around the PCL, leading to posterior knee pain and locking. MRI depicted a diffuse lobulated mass encircling the PCL. During arthroscopic debridement, chalky urate crystals were observed on the articular surfaces during the procedure. Biopsies confirmed the diagnosis of intraarticular tophaceous gout, and the patient showcased significant postoperative improvement. Conclusion: While the diagnosis of soft tissue masses in the knee, notably TGCT and tophaceous gout, poses challenges using conventional radiological tools, our literature review indicates that tophaceous gout in the PCL is seldom suspected in the initial diagnosis of intraarticular tumors due to its resemblance to TGCT on MRI. We emphasize the need for a diagnostic protocol to effectively discern intraarticular tumors of the knee. |
| first_indexed | 2024-03-09T14:03:56Z |
| format | Article |
| id | doaj.art-6c0270b211e7420faafd2628a301963d |
| institution | Directory Open Access Journal |
| issn | 2773-157X |
| language | English |
| last_indexed | 2024-03-09T14:03:56Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Orthopaedic Reports |
| spelling | doaj.art-6c0270b211e7420faafd2628a301963d2023-11-30T05:12:16ZengElsevierJournal of Orthopaedic Reports2773-157X2024-06-0132100275Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature reviewOsama Alzobi0Ayyoub Mohammed1Ashraf Hantouly2Ghislain Aminake3Theodorakys Marín4Bashir Zikria5Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Department of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, Qatar; Corresponding author. Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.Aspetar Orthopaedic and Sports Medicine Hospital, Doha, QatarDepartment of Orthopaedic Surgery, Surgical Specialty Center, Hamad Medical Corporation, Doha, QatarAspetar Orthopaedic and Sports Medicine Hospital, Doha, QatarAspetar Orthopaedic and Sports Medicine Hospital, Doha, QatarAspetar Orthopaedic and Sports Medicine Hospital, Doha, QatarBackground: Tophaceous gout, when manifested as a posterior cruciate ligament (PCL) mass within a joint, is uncommon. Differentiating it from other intraarticular pathologies, notably tenosynovial giant cell tumors (TGCT), previously known as pigmented villonodular synovitis (PVNS), proves challenging. This difficulty arises primarily from the resemblances in their presentation on standard radiological tools such as MRI. Notably, the lesion appearance in tophaceous gout closely aligns with that of TGCT. Case report: We present a case of intraarticular tophaceous gout in a 35-year-old male localized in the posterior chamber of the left knee, particularly around the PCL, leading to posterior knee pain and locking. MRI depicted a diffuse lobulated mass encircling the PCL. During arthroscopic debridement, chalky urate crystals were observed on the articular surfaces during the procedure. Biopsies confirmed the diagnosis of intraarticular tophaceous gout, and the patient showcased significant postoperative improvement. Conclusion: While the diagnosis of soft tissue masses in the knee, notably TGCT and tophaceous gout, poses challenges using conventional radiological tools, our literature review indicates that tophaceous gout in the PCL is seldom suspected in the initial diagnosis of intraarticular tumors due to its resemblance to TGCT on MRI. We emphasize the need for a diagnostic protocol to effectively discern intraarticular tumors of the knee.http://www.sciencedirect.com/science/article/pii/S2773157X23001479GoutTophaceousKnee jointPosterior cruciate ligamentPCLTGCT |
| spellingShingle | Osama Alzobi Ayyoub Mohammed Ashraf Hantouly Ghislain Aminake Theodorakys Marín Bashir Zikria Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review Journal of Orthopaedic Reports Gout Tophaceous Knee joint Posterior cruciate ligament PCL TGCT |
| title | Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review |
| title_full | Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review |
| title_fullStr | Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review |
| title_full_unstemmed | Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review |
| title_short | Tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy: A case report and literature review |
| title_sort | tophaceous gout presented as a posterior cruciate ligament mass and addressed by posterior knee arthroscopy a case report and literature review |
| topic | Gout Tophaceous Knee joint Posterior cruciate ligament PCL TGCT |
| url | http://www.sciencedirect.com/science/article/pii/S2773157X23001479 |
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