Case Reports and SeriesLongitudinal Tears of Peroneus Longus and Brevis Tendons: A Gouty Infiltration
Section snippets
Case Report
A 37-year-old white man presented to our clinic with an approximately 5-year history of recurrent pain, redness, and swelling localized to the posterolateral aspect of his right ankle. The pain was aggravated by ambulation, particularly when he tried to run or play soccer. During the preceding year, his symptoms had worsened, the exacerbations had become much more frequent, and his everyday activities were inhibited by progressively more frequent ankle sprains secondary to inversion
Discussion
Extra-articular tophaceous gout, although not unheard of, is rare in the peroneal tendons. Persistent tophaceous gout is associated with chronic inflammation, which can lead to degeneration of the involved soft tissues and bone. When localized to a tendon, rupture can ensue, because the urate crystals have been shown to lead to a reduction in the tensile strength of the tendon 8, 9. The case we have described in the present report involved both the peroneus longus and the brevis tendons, and
References (9)
- et al.
Peroneus brevis tendon rupture with tophaceous gout infiltration
J Foot Ankle Surg
(1999) - et al.
Longitudinal tears of both peroneal tendons associated with tophaceous gouty infiltration: a case report
J Foot Ankle Surg
(2005) - et al.
Gout: diagnosis, pathogenesis, and clinical manifestations
Curr Opin Rheumatol
(2001) The management of gout
N Engl J Med
(1996)
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Peroneus brevis tendon injuries: Report of two cases and review of literature
2021, Trauma Case ReportsFoot and ankle muscle strength in people with gout: A two-arm cross-sectional study
2016, Clinical BiomechanicsCitation Excerpt :Eversion and inversion motions of the foot, which involve the peroneal and tibialis posterior muscles, are also important throughout the gait cycle, particularly for their contribution to shock absorption and stability (Louwerens et al., 1995). Although the impact that MSU deposition in these ankle structures has on muscle strength remains unclear, several case studies investigating tendon ruptures of the ankle and foot in the gout populations have suggested that the presence of tophi reduces the tensile capacity of tendons (Jerome et al., 2008; Lagoutaris et al., 2005; Radice et al., 2011). Furthermore, the infiltration of tophi into muscle tissues may potentially reduce the functional cross-sectional muscle area (i.e. area of active working muscle) and thereby the potential to generate force (Kao et al., 2012).
Structural joint damage in gout
2014, Rheumatic Disease Clinics of North AmericaCitation Excerpt :Finally, a recent study using DECT in patients with tophaceous gout showed that 10.8% of tendon sites in the feet had MSU crystal deposition, with the Achilles tendon being the most commonly affected tendon of those assessed (see Fig. 1B, C).77 Although tendon damage is not as clinically apparent as cartilage and bone damage in patients with advanced gout, cases of tendon rupture that may have been associated with the presence of MSU crystals or tophi have been reported.78,79 Tophus infiltration into tendons has also been observed during surgery.80–82
Shoulder gouty arthritis with tophus: a case report and literature review
2020, Chinese Journal of Orthopaedics
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Conflict of Interest: None reported.