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A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout

Gout is a crystal deposition disorder caused due to the deposition of monosodium urate crystals in joints and other tissues secondary to hyperuricemia. Podagra is the term for gout of the first metatarsophalangeal joint. In our case report, a 30-year-old male patient came to our OPD with complaints...

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Autores principales: Sravan, Vellanki, Solunke, Swaroop, Abhyankar, Rushikesh, Nair, Vinod
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817486/
https://www.ncbi.nlm.nih.gov/pubmed/36628000
http://dx.doi.org/10.7759/cureus.32285
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author Sravan, Vellanki
Solunke, Swaroop
Abhyankar, Rushikesh
Nair, Vinod
author_facet Sravan, Vellanki
Solunke, Swaroop
Abhyankar, Rushikesh
Nair, Vinod
author_sort Sravan, Vellanki
collection PubMed
description Gout is a crystal deposition disorder caused due to the deposition of monosodium urate crystals in joints and other tissues secondary to hyperuricemia. Podagra is the term for gout of the first metatarsophalangeal joint. In our case report, a 30-year-old male patient came to our OPD with complaints of swelling over the first metatarsophalangeal joint for one year, which was insidious in onset, localized, and had a sudden increase in size over the past three months. The patient also complained of an inability to properly wear his shoe. A plain radiograph was done, which was suggestive of an expansile lesion with the destruction of the first metatarsophalangeal joint and the erosion of the joint surface extending to the head of the first metatarsal and the proximal phalanx of the great toe. Lab investigations revealed a serum uric acid level of 10.2 mg/dl and an acid phosphatase level of 8.92 U/L. Excision of the lesion was done and a frozen section biopsy was sent intra-operatively which confirmed the presence of monosodium urate crystals. A fibular strut graft was taken to fill the defect using a square nail passing through the first metatarsophalangeal joint and a Kirschner wire was added to the interphalangeal joint to maintain the stability of the reduction. The foot was immobilized for six weeks following which the Kirschner wire was removed and range-of-motion exercises started. There was no residual deformity, and the patient responded well to the treatment.
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spelling pubmed-98174862023-01-09 A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout Sravan, Vellanki Solunke, Swaroop Abhyankar, Rushikesh Nair, Vinod Cureus Urology Gout is a crystal deposition disorder caused due to the deposition of monosodium urate crystals in joints and other tissues secondary to hyperuricemia. Podagra is the term for gout of the first metatarsophalangeal joint. In our case report, a 30-year-old male patient came to our OPD with complaints of swelling over the first metatarsophalangeal joint for one year, which was insidious in onset, localized, and had a sudden increase in size over the past three months. The patient also complained of an inability to properly wear his shoe. A plain radiograph was done, which was suggestive of an expansile lesion with the destruction of the first metatarsophalangeal joint and the erosion of the joint surface extending to the head of the first metatarsal and the proximal phalanx of the great toe. Lab investigations revealed a serum uric acid level of 10.2 mg/dl and an acid phosphatase level of 8.92 U/L. Excision of the lesion was done and a frozen section biopsy was sent intra-operatively which confirmed the presence of monosodium urate crystals. A fibular strut graft was taken to fill the defect using a square nail passing through the first metatarsophalangeal joint and a Kirschner wire was added to the interphalangeal joint to maintain the stability of the reduction. The foot was immobilized for six weeks following which the Kirschner wire was removed and range-of-motion exercises started. There was no residual deformity, and the patient responded well to the treatment. Cureus 2022-12-07 /pmc/articles/PMC9817486/ /pubmed/36628000 http://dx.doi.org/10.7759/cureus.32285 Text en Copyright © 2022, Sravan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Urology
Sravan, Vellanki
Solunke, Swaroop
Abhyankar, Rushikesh
Nair, Vinod
A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout
title A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout
title_full A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout
title_fullStr A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout
title_full_unstemmed A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout
title_short A Rare Case of Destruction of the First Metatarsophalangeal Joint in a Patient With Gout
title_sort rare case of destruction of the first metatarsophalangeal joint in a patient with gout
topic Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817486/
https://www.ncbi.nlm.nih.gov/pubmed/36628000
http://dx.doi.org/10.7759/cureus.32285
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