Intraarticular Tophi in a Joint Without a Previous Gouty Attack

KUANG-HUI YU

ABSTRACT.

Subcutaneous tophi are usually a late clinical manifestation of gout. However, intraarticular tophi may develop very early, since crystal shedding has been presumed to precipitate an acute gouty attack. There is little direct evidence of intraarticular tophi before the initial gouty attack. We describe a patient who had gout for 3 years without subcutaneous tophi. Whitish intraarticular deposits, presumably representing urate tophi, were noted during right knee arthroscopy for a posterior cruciate ligament tear. This observation illustrates that tophi deposition may occur early, even in previously unaffected joints. (J Rheumatol 2003;30:1868-70)

Key Indexing Terms:

GOUT
ARTHROSCOPE
TOPHI
INTRAARTICULAR

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From the Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.

K.H. Yu, MD, Attending Physician.

Address reprint requests to Dr. K.H. Yu, Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kuei-Shan, Tao-Yuan, Taiwan. E-mail: gout@adm.cgmh.org.tw

Submitted April 17, 2002; revision accepted January 8, 2003.

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