Pathological Fracture Of Long Bone Secondory To Tophious Gout - A Case Report And Revew Of Literature

Abstract

Gout is a systemic metabolic disease affecting more than 1% of the population. Four clinical stages (asymptomatic hyper uricemia, acute gouty arthritis, interstitial gout, and chronic tophaceous gout) are described. Tophi may appear at any site, but the most common sites are the digits or the ears, hand and of the the feet and the olecranon bursa. A 28-year-old man sustained fracture on tibia after trivial trauma in same limb operated 10 year back. Intraoperativly at fracture site there is massive chalky white deposit found. After thorough investigation of patient and histopathological examination of deposit found that patient has high normal level of serum uric acid. Biopsy report shows touphious deposit. All other differential diagnosis chalky white material was ruled out. Patient did not have any history and clinical feature of any joint involment. We present a case of postoperatively deposition of gouty tophi in subclinical gout in around 10 year old implant of tibia and causes pathological fracture of long bone after trival trauma. Gout is a systemic metabolic disease affecting more than 1% of the population. Four clinical stages (asymptomatic hyper uricemia, acute gouty arthritis, intersriticial gout, and chronic tophaceous gout) are described. Chronic tophaceous gout usually develops 10 or more years of acute intermittent gout, although in rare cases tophi may be the initial manifestation of the disease. Tophi may appear at any site, but the most common sites are the digits or the ears, hand and of the the feet and the olecranon bursa. Also, tophi may be associated with destructive deforming arthritis. In these cases the differential diagnosis with other types of arthritis should be done. We present a case of 28 year male postoperatively deposition of gouty tophi around 10 year old implant of tibia and causes pathological fracture of long bone after trivial trauma. patient did not have any history and clinical feature of any joint involment.