This case report describes an unusual form of gout, called miliarial gout, in association with carpal tunnel syndrome in a 54-year-old woman. Miliarial gout was first described in 2007 and is a very rare presentation of chronic tophaceous gout. The latter condition can cause carpal tunnel syndrome, but this association has not previously been described in association with miliarial gout. In addition, the authors discuss the use of the parsimony principle in internal medicine whereby a single cause is first sought for different symptoms presenting at the same time.
Learning points:
Miliarial gout, a form of chronic tophaceous gout, is a very rare clinical presentation of the disease.Patients with miliarial gout, despite subcutaneous nodules, may present with other organ involvement.Carpal tunnel syndrome in patients with gout may be caused by monosodium urate crystal deposition.