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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions). In this respect, electronic databases (ISI Web of Science, PubMed, Elsevier Science Direct) and reference lists of relevant articles/reviews were screened by two blinded investigators for each topic. The main medical subject heading terms selected to capture the most relevant papers on the topics in accordance with the literature were knee/hip/hand osteoarthritis, prevalence, rotator cuff injury, lateral epicondylitis, tendinopathy, rheumatoid arthritis, Sjogren's syndrome, polymyalgia rheumatica, crystal arthropathies, gout, pseudogout, carpal tunnel syndrome, fall, fractures, hematoma, pressure ulcer, ultrasonography, interventional, sarcopenia, body composition, rehabilitation, frail elderly, and aged. The search was limited to peer-reviewed full-text English journals starting from the earliest papers to May 2017. A study population (or part of the study population) of adults older than 65 years (if possible) was included. We especially underscore the use of US by clinicians as an extension of their physical examination or as a practical guide for an immediate intervention.
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PMID:The value of musculoskeletal ultrasound in geriatric care and rehabilitation. 2869 51

Gout is a common form of inflammatory arthritis, and the majority of gout patients experience recurrent acute attacks, joint damage, and other complications. Carpal tunnel syndrome caused by gouty tophi indicates the severity of untreated gouty tophi. In this article, we report a 54-year- old male chronic gout patient with serious carpal tunnel syndrome secondary to monosodium urate crystal deposit. The patient was admitted to our department with palmar numbness and disability for two years. He had a history of gout for 30 years but received no treatment. Multiple monosodium urate crystals were observed to be deposited in and around carpal tunnel on the three-dimensional reconstruction using dual energy computed tomography, which confirmed the diagnosis. The needle biopsy and electrophysiological test also supported the diagnosis. Our case indicates that dual energy computed tomography is a useful method to diagnose carpal tunnel syndrome associated with gout and that we should keep in mind the possibility of gouty tophi as a possible cause of carpal tunnel syndrome.
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PMID:Severe Carpal Tunnel Syndrome Caused by Gouty Tophi Diagnosed by Dual Energy Computed Tomography: Case Report. 2990 Sep 61

Carpal tunnel syndrome (CTS) is well recognized as the most common type of peripheral neuropathy. A rare cause of CTS is tophaceous gout. Tophi deposits can accumulate in various structures including the flexor tendons, tendon sheaths, the carpal tunnel floor, transverse carpal ligament, and even the median nerve, causing various symptoms such as pain, numbness, and weakness. Tophi forming in the carpal canal can compress the median nerve, leading to CTS. Here, we describe a 25-year-old male with a family history of tophaceous gout who presented with typical CTS symptoms. Although he had chronic numbness in his right hand, he failed to present with any obvious palpable masses on his forearm or hand. However, his family history, laboratory, clinical, and magnetic resonance imaging findings were consistent with tophi deposits. CTS symptoms were eased through surgical removal of tophi and decompression of the median nerve. No recurrences of gout and CTS symptoms were reported at a one-year follow-up. This case shows that CTS symptoms could be the initial manifestation of tophaceous gout. In patients with a family history of gout and with CTS symptoms, imaging examinations are critical for early diagnosis and selecting appropriate treatment. Surgical removal of "covert" tophi and decompression of the median nerve is an effective option for eliminating symptoms.
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PMID:Chronic carpal tunnel syndrome caused by covert tophaceous gout: A case report. 3021 Dec 8

This case report describes an unusual form of gout, called miliarial gout, in association with carpal tunnel syndrome in a 54-year-old woman. Miliarial gout was first described in 2007 and is a very rare presentation of chronic tophaceous gout. The latter condition can cause carpal tunnel syndrome, but this association has not previously been described in association with miliarial gout. In addition, the authors discuss the use of the parsimony principle in internal medicine whereby a single cause is first sought for different symptoms presenting at the same time.
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PMID:Chronic Miliarial Gout Associated with Carpal Tunnel Syndrome: A Very Rare Clinical Presentation. 3075 65

Deposition of tophus is a common feature in chronic gout; however, signs and symptoms are not always well-pronounced in cases of uncommon sites. We report a case series of three patients, one with an acute locked knee suspected to be meniscus tear or intra-articular loose body, a second case with a lump on the dorsal hand suspected to be a benign lesion, and a third case with a finger flexion deformity with carpal tunnel syndrome; all three cases were later on found out to be tophaceous gout. White chalky monosodium urate crystal deposition was found to be the culprit of the symptoms of the patients.
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PMID:Atypical musculoskeletal manifestations of gout in hyperuricemia patients. 3079 62


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