scholarly journals Bilateral elbow indirect Cubital tunnel syndrome due to mass effect of Gouty tophi

2021 ◽  
Vol 13 (4) ◽  
pp. 70-73
Author(s):  
Akshay Lekhi
Keyword(s):  
Uric Acid ◽  
Case Reports ◽  
Surgical Excision ◽  
Mass Effect ◽  
Cubital Tunnel Syndrome ◽  
Pharmaceutical Drugs ◽  
Monosodium Urate ◽  
Tophaceous Gout ◽  
Tunnel Syndrome ◽  
Urate Crystals

Gout is an inflammatory arthritis associated with raised uric acid levels in blood. The pathology involves infiltration and destruction of ligament, cartilage, tendons, bone and skin by deposition of urate crystals. Our purpose of writing this case is to report rare bilateral neurological symptoms due to compression, by tophaceous gout around elbows. A 32-year-old male had presented with episodic tingling in bilateral ulnar nerve distributions for fourteen days. Surgical excision of the tophi around elbows that were causing the neural compression symptoms was done and symptoms relieved gradually over 6 weeks. Tophi are late presentations. They can present with symptoms from depositing at different sites that is evidenced in existing literature case reports. Controlling serum uric acid levels below deposition threshold either by dietary or pharmaceutical drugs is the mainstay of management, resulting in dissolution of monosodium urate crystals.

A case of severe gouty tophi-induced carpal tunnel syndrome: Operative finding and its outcome

2018 ◽  
Vol 50 (01) ◽  
pp. 19-21 ◽  
Author(s):  
Jun-Ku Lee ◽  
Ju Won Kim ◽  
Yoon Seok Kim ◽  
Bon San Koo
Keyword(s):  
Uric Acid ◽  
Severe Pain ◽  
Functional Disability ◽  
Soft Tissues ◽  
Joint Motion ◽  
Monosodium Urate ◽  
Joint Deformity ◽  
Tunnel Syndrome ◽  
Synovial Tissues ◽  
Urate Crystals

IntroductionGout is a disease featuring acute arthritis, joint deformity and severe pain caused through the deposition of monosodium urate crystals in and around synovial tissue 1. Tophi are stone-like deposits of monosodium urate in the soft tissues, synovial tissues, or bones adjacent to the joints. The tophi can compromise joint motion and deteriorate bony structure, finally leading to functional disability. Therefore, early treatment using uric acid lowering agents is standard practice in gout patients to prevent the formation of tophi through controlling uric acid levels.

Biostatistical Analysis and Possible Forecasting of Relationship Between Uric Acid and Specific Laboratory Tests in Cases of Gouty Arthritis

2017 ◽  
Vol 68 (6) ◽  
pp. 1234-1241
Author(s):  
Adina Octavia Duse ◽  
Delia Berceanu Vaduva ◽  
Mirela Nicolov ◽  
Cristina Trandafirescu ◽  
Marcel Berceanu Vaduva ◽  
...  
Keyword(s):  
Uric Acid ◽  
Laboratory Tests ◽  
Gouty Arthritis ◽  
Main Diagnosis ◽  
Monosodium Urate ◽  
Glutamate Pyruvate ◽  
Metatarsophalangeal Joints ◽  
The Relationship ◽  
Biostatistical Analysis ◽  
Urate Crystals

Acute gouty arthritis represents an inflammatory response to microcrystals of monosodium urate that precipitate in joint tissues from supersaturated body fluids or are shed from preexisting articular deposits [1]. Gout is a metabolic disease characterized by recurrent episodes of arthritis associated with the presence of monosodium urate crystals in the tissue or synovial fluid during the attack.These forms of crystal-induced arthritis usually affect peripheral joints, including knee, ankle, wrist, and metacarpophalangeal and metatarsophalangeal joints. All of them may be associated with other inflammatory, endocrine diseases [2]. The present study was done to highlight the relationship between increased levels of uric acid and specific laboratory tests in order to possible forecast development of further disease in patients with gouty arthrithis.The present study was done on 34 patients hospitalized in Felix Hospital of Rehabilitation in 2015-2016, with age between 44 and 74, having the main diagnosis of gouty arthritis.We studied the following laboratory tests:urea and other related analysis, like uric acid, creatinine, cholesterol, glutamate pyruvate transaminase and glutamate oxalate transaminase.

scholarly journals Hyperuricemia and Gout – Ins and Out

2020 ◽  
Vol 15 (2) ◽  
pp. 227-234
Author(s):  
Md Abdur Razzak ◽  
Quazi Audry Arafat Rahman ◽  
Fahtiha Nasreen
Keyword(s):  
Gouty Arthritis ◽  
Polarized Light ◽  
Acute Gout ◽  
Women Patients ◽  
Monosodium Urate ◽  
Tophaceous Gout ◽  
First Metatarsal ◽  
Birefringent Crystals ◽  
Inflammatory Drugs ◽  
Urate Crystals

Gout is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue. The four phases of gout include asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. The peak incidence occurs in patients 30 to 50 years old, and the condition is much more common in men than in women. Patients with asymptomatic hyperuricemia do not require treatment, but efforts should be made to lower their urate levels by encouraging them to make changes in diet or lifestyle. Acute gout most commonly affects the first metatarsal joint of the foot, but other joints are also commonly involved. Definitive diagnosis requires joint aspiration with demonstration of birefringent crystals in the synovial fluid under a polarized light microscope. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids and analgesics. In patients without complications, NSAID therapy is preferred. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 227-234

scholarly journals Tu-Teng-Cao Extract Alleviates Monosodium Urate-Induced Acute Gouty Arthritis in Rats by Inhibiting Uric Acid and Inflammation

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Rongmei Yao ◽  
Zihan Geng ◽  
Xin Mao ◽  
Yanyan Bao ◽  
Shanshan Guo ◽  
...  
Keyword(s):  
Uric Acid ◽  
Gouty Arthritis ◽  
Histological Evaluation ◽  
Therapeutic Effects ◽  
Monosodium Urate ◽  
Cell Degeneration ◽  
Acute Gouty Arthritis ◽  
Monosodium Urate Crystals ◽  
Potassium Oxonate ◽  
Urate Crystals

Gouty arthritis is an inflammatory joint disease closely related to hyperuricemia. It is characterized by deposition of monosodium urate crystals in the joints, resulting in an intense inflammatory process and pain. Control of hyperuricemia and anti-inflammation treatments are the main therapeutic approaches. However, the commonly used drugs for inhibiting uric acid and acute gouty arthritis have obvious gastrointestinal and renal toxicity; thus, there is an urgency to develop new alternative therapeutic drugs. An extract of Tu-Teng-Cao (TTC), a compound drug used in traditional Chinese medicine, has been widely applied to the clinical treatment of arthritis. In this study, we investigated the therapeutic effects of TTC on gouty arthritis. In this study, an animal model of acute gouty arthritis with hyperuricemia was established using potassium oxonate and monosodium urate crystals. After treatment with TTC, the results showed obvious therapeutic effects on the rat model of acute gouty arthritis. The treatment significantly attenuated the degree of ankle swelling, inflammation, and dysfunction index, and the levels of proinflammatory cytokines. In addition, TTC has significant antihyperuricemia activity in rats with hyperuricemia induced by potassium oxonate. Histological evaluation showed that TTC relieved pathological damage in rats with acute gouty arthritis induced by monosodium urate crystals. All the groups treated with TTC showed improvement in cartilage degeneration, cell degeneration, synovial hyperplasia, and inflammatory cell invasion in the ankle joint of rats. TTC significantly alleviated swelling, inflammation, and bleeding of the renal corpuscle and convoluted tubules of rats. The results of this study suggest that TTC is capable of treating gouty arthritis and decreasing ankle injury through the control of uric acid and inflammation.

THU0023 Soluble Uric Acid Exerts a Suppressive Effect on the Response of Macrophages to Monosodium Urate Crystals

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 201.1-201
Author(s):  
E. Garcia-Melchor ◽  
M. Guma ◽  
J. Yagüe ◽  
M. Juan ◽  
J. Harper
Keyword(s):  
Uric Acid ◽  
Suppressive Effect ◽  
Monosodium Urate ◽  
Monosodium Urate Crystals ◽  
Urate Crystals

Fibroma of tendon sheath of the hand: a series of 20 patients with 23 tumours

2012 ◽  
Vol 39 (3) ◽  
pp. 300-305 ◽  
Author(s):  
M.M. Al-Qattan
Keyword(s):  
Case Reports ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Palmar Fascia ◽  
Female Ratio ◽  
Tunnel Syndrome ◽  
Current Article ◽  
Painless Mass ◽  
Male To Female

Fibroma of tendon sheath is an uncommon fibrous tumour that has a predilection for the hand. Large series from Histopathological Units report a local recurrence rate of 24% after surgical excision. In the hand/orthopaedic surgery literature, fibroma of tendon sheath was generally reported as isolated case reports with unusual presentations, such as triggering and carpal tunnel syndrome. The current article reports on a series of 23 tumours of the hands of 20 patients. These were all adults (mean age of 36 years) with a male to female ratio of 3:1. The thumb and index were the most common sites. A slow-growing painless mass was the clinical presentation in every case. Total surgical excision was ensured by excision of part of flexor sheath/palmar fascia to which the tumour was attached. Diagnosis was confirmed by the classic histological features of fibroma of tendon sheath. There were no recurrences at final follow-up 2–5 years after surgery.

scholarly journals Febuxostat and Increased Dialysis as a Treatment for Severe Tophaceous Gout in a Hemodialysis Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Lynda Ann Frassetto ◽  
Suzanne Gibson
Keyword(s):  
Uric Acid ◽  
Vascular Endothelium ◽  
Marked Improvement ◽  
Hemodialysis Patient ◽  
Uremic Toxin ◽  
Kidney Tubules ◽  
Tophaceous Gout ◽  
Renal Interstitium ◽  
Inflammatory Changes ◽  
Urate Crystals

Uric acid accumulates in renal failure and is thought to be a uremic toxin—that is, higher levels of uric acid are more damaging to the kidneys. Urate crystals can precipitate in the kidney tubules, cause urate stones, and promote inflammatory changes in the renal interstitium and vascular endothelium. Uric acid is also a small non-protein-bound molecule and therefore easily dialyzable. Here, we present the case of an anuric hemodialysis patient with severe tophaceous gout who regained some renal function and whose gout burden significantly decreased resulting in marked improvement in functional status using a new gout medication, febuxostat, and increased frequency of dialysis.

Xanthine oxidoreductase and its inhibitors: relevance for gout

2016 ◽  
Vol 130 (23) ◽  
pp. 2167-2180 ◽  
Author(s):  
Richard O. Day ◽  
Bishoy Kamel ◽  
Diluk R.W. Kannangara ◽  
Kenneth M. Williams ◽  
Garry G. Graham
Keyword(s):  
Uric Acid ◽  
Xanthine Oxidoreductase ◽  
Monosodium Urate ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Saturation Point ◽  
First Line Therapy ◽  
And Function ◽  
Rate Limiting ◽  
Over 40 Years ◽  
Urate Crystals

Xanthine oxidoreductase (XOR) is the rate-limiting enzyme in purine catabolism and converts hypoxanthine to xanthine, and xanthine into uric acid. When concentrations of uric acid exceed its biochemical saturation point, crystals of uric acid, in the form of monosodium urate, emerge and can predispose an individual to gout, the commonest form of inflammatory arthritis in men aged over 40 years. XOR inhibitors are primarily used in the treatment of gout, reducing the formation of uric acid and thereby, preventing the formation of monosodium urate crystals. Allopurinol is established as first-line therapy for gout; a newer alternative, febuxostat, is used in patients unable to tolerate allopurinol. This review provides an overview of gout, a detailed analysis of the structure and function of XOR, discussion on the pharmacokinetics and pharmacodynamics of XOR inhibitors–allopurinol and febuxostat, and the relevance of XOR in common comorbidities of gout.

scholarly journals HIPERURISEMIA DAN RESPONS IMUN

2013 ◽  
Vol 3 (2) ◽  
Author(s):  
Aaltje E. Manampiring
Keyword(s):  
Uric Acid ◽  
Essential Role ◽  
Adult Population ◽  
Monosodium Urate ◽  
Metabolic Disturbances ◽  
Monosodium Urate Crystals ◽  
Cytokines And Chemokines ◽  
Urate Crystal ◽  
Urate Crystals

Abstract: Hyperuricemia, a highly prevalent condition in adult population, is associated with hemodynamic and metabolic disturbances. Albeit, pathophysiological aspects of hyperuricemia are still not clearly understood. Uric acid plays an essential role in immunity by induction of some cytokines and chemokines, such as TNFα, Il-1β, IL-6, CXCL8 (IL-8), and CXCL1 (growth-related oncogene α). Deposits of monosodium urate crystals in joint cavities and periarticular tissues  are related to an autoinflammatory disturbance, namely gout. Keywords: hyperuricemia, monosodium urate crystal, immune responsse.   Abstrak: Hiperurisemia merupakan suatu keadaan yang umum dijumpai pada populasi dewasa dan berhubungan dengan kelainan metabolik dan hemodinamik. Aspek patofisiologik dari hiperurisemia belum sepenuhnya dipahami dengan jelas. Asam urat berperan penting dalam imunitas dengan menginduksi berbagai sitokin dan kemokin, antara lain TNFα, Il-1β, IL-6, CXCL8 (IL-8) dan CXCL1 (growth-related oncogene α). Deposit kristal monosodium urat di dalam rongga sendi dan jaringan periartikuler berkaitan dengan gangguan autoinflamasi yang dikenal sebagai gout. Kata kunci: hiperurisemia, kristal monosodium urat, respons imun.

Effect of dry needling on cubital tunnel syndrome: Three case reports

2018 ◽  
Vol 35 (4) ◽  
pp. 363-372 ◽  
Author(s):  
Sudarshan Anandkumar ◽  
Murugavel Manivasagam
Keyword(s):  
Case Reports ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Dry Needling ◽  
Tunnel Syndrome
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