Abstract
BackgroundTalus osteochondral lesion is commonly associated with trauma, avascular necrosis or even genetic factors, but gouty tophus as a cause of Hepple stage V type talus osteochondral lesion is rare.Case presentationHere, we report a case of an 18-year-old man who complained of left medial deep ankle pain on ambulation. This young man had an extreme liking of sea food rich in purines and also sugar-sweetened drinks. He was diagnosed with a Hepple stage V type talus osteochondral lesion and was treated with medial malleolus osteotomy and an osteochondral graft. The talus osteochondral lesion was found to be a gouty tophus and was completely removed. Hypouricemic therapy was prescribed for 2 months, which allowed the patient to walk with a visual analogue score (VAS) score of 1. He was followed up for 12 months.ConclusionsYoung people with an extreme liking of sea food rich in purines and also sugar-sweetened drinks may be at a risk of developing gout. Acute onset of ankle atraumatic pain, swelling with a high level of serum uric acid and a talus osteochondral lesion with cyst formation should make physicians consider a diagnosis of gout.
Highlights
ConclusionsYoung people with an extreme liking of sea food rich in purines and sugar-sweetened drinks may be at a risk of developing gout
Talus osteochondral lesion is commonly associated with trauma, avascular necrosis or even genetic factors, but gouty tophus as a cause of Hepple stage V type talus osteochondral lesion is rare.Case presentation: Here, we report a case of an 18-year-old man who complained of left medial deep ankle pain on ambulation
Young people with an extreme liking of sea food rich in purines and sugar-sweetened drinks may be at a risk of developing gout
Summary
Gout is mainly diagnosed in the aged population, young people who like extreme diets that include sea food rich in purines, beer and sugar-sweetened carbonated drinks may be at risk of prematurely developing gout. A severe talus osteochondral lesion occurred in our young patient without previous gout flares. An acute onset of ankle atraumatic pain, swelling with a high concentration of serum uric acid and a talus osteochondral lesion with cyst formation should make a physician think of gout as the diagnosis. A Hepple stage V type talus osteochondral lesion due to gouty tophus can be successfully managed with an autologous osteochondral graft combined with uric acidlowering therapy and diet modification
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