Abstract
This is a case of acute left hip pain in a young male patient presenting to the Emergency Department (ED). The hip joint is painful with limited range of motion, and the patient is admitted to rule out septic arthritis of the hip. The subsequent inpatient serum uric acid level performed is elevated and the Magnetic Resonance Imaging (MRI) hip reveals a moderate hip effusion. A Computer Tomography (CT) guided hip joint aspiration confirms the diagnosis of gout with uric acid crystals seen in the hip synovial fluid analysis. The patient is treated as for gout with marked improvement in his symptoms.
Highlights
Acute hip pain often brings people to the Emergency Department (ED) as it affects their mobility and function
A 29-year-old technician presented with 2-day history of progressively worsening left hip pain, which was accompanied by low-grade fever
Where clinical suspicion is high, to differentiate between the two diagnoses, positive joint fluid examination for uric acid crystals and positive joint fluid cultures are needed for the diagnoses of gout and septic arthritis respectively
Summary
Acute hip pain often brings people to the ED as it affects their mobility and function. Hip radiographs are often performed to rule out fractures in patients with a preceding injury. In cases of no preceding injury, conditions such as a hip osteoarthritis, avascular necrosis, infection and inflammatory conditions must be considered. Gout is a common inflammatory arthritis caused by deposition of monosodium urate crystals within the joints. It is often associated with elevated serum hyperuricaemia. The involvement of gout in the shoulder and hip joint is exceedingly uncommon. Risk factors include medications that increase uric acid levels like diuretics, purine containing foods like meat, and ingestion of alcohol. We report a rare case of gout in the hip of a young adult patient
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