>> Contexte clinique:
Douleur chronique et volumineux nodule du 3e doigt de la main droite.
>> Interprétation:
La goutte est une arthropathie microscristalline causée par le dépôt d'urates de sodium dans les articulations (et autour des articulations). La radiographie présentée ici montre une forme évoluée et chronique de la goutte, après plusieurs années d'évolution avec notion de poussées aiguës mal traitées. Remarquez le volumineux nodule sous-cutané du 3e doigt (tophus goutteux).
Texte original: Gout is a crystal arthropathy due to deposition of monosodium urate crystals in and around the joints. There is a strong male predilection (20:1). Four stages of gout are seen - asymptomatic hyperuricaemia, acute gouty arthritis, intercritical gout (between acute attacks) and chronic tophaceous gout.
Characteristic radiologic changes occur in the chronic stage, though not all patients progress to this. There is a predilection for the small joints of the hands and feet. The typical appearance is well-defined “punched-out” erosions with sclerotic margins in a marginal and juxta-articular distribution, with overhanging edges. The joint space is preserved until late. Chondrocalcinosis is present in 5%. Periarticular soft tissue swelling due to crystal deposition in tophi around the joints is common. This soft tissue swelling may be hyperdense due to the crystals, and the tophi frequently calcify.
Douleur chronique et volumineux nodule du 3e doigt de la main droite.
>> Interprétation:
La goutte est une arthropathie microscristalline causée par le dépôt d'urates de sodium dans les articulations (et autour des articulations). La radiographie présentée ici montre une forme évoluée et chronique de la goutte, après plusieurs années d'évolution avec notion de poussées aiguës mal traitées. Remarquez le volumineux nodule sous-cutané du 3e doigt (tophus goutteux).
Texte original: Gout is a crystal arthropathy due to deposition of monosodium urate crystals in and around the joints. There is a strong male predilection (20:1). Four stages of gout are seen - asymptomatic hyperuricaemia, acute gouty arthritis, intercritical gout (between acute attacks) and chronic tophaceous gout.
Characteristic radiologic changes occur in the chronic stage, though not all patients progress to this. There is a predilection for the small joints of the hands and feet. The typical appearance is well-defined “punched-out” erosions with sclerotic margins in a marginal and juxta-articular distribution, with overhanging edges. The joint space is preserved until late. Chondrocalcinosis is present in 5%. Periarticular soft tissue swelling due to crystal deposition in tophi around the joints is common. This soft tissue swelling may be hyperdense due to the crystals, and the tophi frequently calcify.
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