Tophaceous gout in the sternoclavicular joint. Issue 10 (14th October 2020)

• Record Type: Journal Article
• Authors: Sahdev, Nikhil; Smelt, Jeremy; Avila, Zoe; Tennent, Duncan; Hunt, Ian
• Is Part Of: Journal of surgical case reports. Volume 2020:Issue 10(2020)
• Publication Date: 2020-10-14
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjaa398
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: Gouty arthritis commonly occurs in peripheral synovial joints and involvement in the thoracic cage is extremely rare. We report a case of a 52-year-old presenting with a painful bony mass in her sternal notch. Imaging demonstrated a lobulated calcified and necrotic lesion causing mass effect on adjacent structures. Excision biopsy confirmed a benign cystic lesion with amorphous material containing needle-shaped refractile crystals suggestive of uric acid. Tophaceous gout was diagnosed. Presence of a periarticular mass with characteristics of gout should warrant investigation with biopsy and imaging. This can prevent misdiagnosis of malignancy and avoid unnecessary surgery in asymptomatic lesions.