Tophi gout around the knee joint: An unusual presentation with a soft tissue mass

ünlü özkan f., bilsel k., türkmen i., erdil m., ÖZKAN K.

international journal of case reports and images, vol.4, pp.1-4, 2013 (Peer-Reviewed Journal)

  • Publication Type: Article / Case Report
  • Volume: 4
  • Publication Date: 2013
  • Journal Name: international journal of case reports and images
  • Journal Indexes: Index Copernicus
  • Page Numbers: pp.1-4


Introduction: Gout is the most common
inflammatory arthropathy. It has been reported
to affect 2.13% of population in the United states.
In this report we aimed to present an uncommon
case of tophaceous gout of the knee presenting as
a soft tissue mass. case report: A 57-year-old male
patient with knee pain and localized progressive
swelling increasing in time on the medial side
of the proximal tibia was seen in our clinic. He
did not have any rheumatologic disease known
previously except gout arthritis. Excisional biopsy
Feyza Unlu Ozkan1
, Kerem Bilsel2
, Ismail Turkmen3
, Mehmet
, Salih Soylemez3
, Korhan Ozkan3
Affiliations: 1
MD, Fatih Sultan Mehmet Education and
Research Hospital; Physical Medicine and Rehabilitation
Department; Istanbul, Turkey; 2
MD, Bezmialem Vakif
University; Orthopaedic and Traumatology Department;
Istanbul, Turkey; 3
MD, Istanbul Medeniyet University
Goztepe Education and Research Hospital; Orthopedics
and Traumatology Department; Istanbul, Turkey.
Corresponding Author: Kerem BILSEL, MD, Bezmialem
Vakif Universitesi, Ortopedi ve Travmatoloji AD, 34093,
Fatih, Istanbul, TURKEY; Tel: +905322918291; Fax:
+902125332326; E-mail:
Received: 13 February 2013
Accepted: 19 June 2013
Published: 01 November 2013
was performed by preserving medial collateral
ligament and histopathologic investigations
were done next. A tophaceous gouty deposit was
identified by low-power photomicrograph. A
bluish amorphous material was seen surrounded
by bundles of dense collagenized tissue and
chronic inflammatory cells. surrounding the
amorphous crystalline deposit is a thin layer of
mononuclear and giant cells. Photomicrograph of
another section has been stained by de Galantha’s
method for demonstration of monosodium urate
crystals. conclusion: Especially in patients with
extra-articular or subcutaneus mass, tophaceous
gout must be considered as differential diagnosis.
Keywords: tophi gout, de Galantha’s