Abstract
Gout is a form of inflammatory arthritis caused by hyperuricemia characterized by painful, hot and swollen joints. However, tophi involving carpal tunnel with concomitant presence of finger movement dysfunction as the first presentation of gout is rare. This suggests the involvement of flexor tendon inside the carpal tunnel. Here, we report a case of infiltration of tophi at the flexor tendon of the hand presented as the first clinical manifestation of gout causing trigger finger like symptoms. Patient underwent surgery to confirm the diagnosis and improve flexor tendon excursion. Our patient’s finger movement improved dramatically after operation.
Highlights
Gout is one the commonest inflammatory arthropathy, affecting more than 8 million Americans [1]
Gout is a form of inflammatory arthritis caused by hyperuricemia characterized by painful, hot and swollen joints
Tophi involving carpal tunnel with concomitant presence of finger movement dysfunction as the first presentation of gout is rare. This suggests the involvement of flexor tendon inside the carpal tunnel
Summary
Gout is one the commonest inflammatory arthropathy, affecting more than 8 million Americans [1]. The disease characterized by painful joint inflammation, frequently involves first metatarsophalangeal joint [2]. Diagnosis is often made clinically and confirmed by identification of monosodium urate crystal in the synovial fluid of the affected joint. Tophi is normally present in long term disease and generally located in elbow, ear pinna and Achilles tendon. Tophi involve the flexor tendons in the hand as the first presentation of gout is uncommon [3]. Rarity of this injury leads to scarcity of reports detailing its management and outcome.
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