PMC6477753_01
Preoperative clinical sign showed trigger-like symptom and locking of the
metacarpophalangeal joint of the left middle finger. Gouty tophus was
deposited under the skin of the fingertip.
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A 63-year-old man complained at our outpatient department of a sudden inability to extend the middle finger of his right hand (Figure 1).
Radiograph and CT of the metacarpal head of the middle finger showing that
the radial condyle tip had a sharp osteophyte.
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Radiographs and computed tomography (CT) showed ulnar deviation of the left fingers and osteophytes on the radial lateral aspects of the metacarpal head of the right middle finger and osteoarthritic change of the distal radioulnar joint (Figure 2).
Intraoperative aspect of the flexor superficialis tendon of the middle finger
showing the mass filled with a chalky white substance.
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With carpal tunnel release, flexor digitorum superficialis (FDS) tendon and flexor digitorum profundus (FDP) of the middle finger were found with multiple involved white lesions (Figure 3).
Histopathological evaluation of a section of resected tissue showing an
eosinophilic amorphous gouty tophus deposit like needles surrounded by
chronically inflamed cells, multinucleated giant cells, and fibrillations
(hematoxylin-eosin stain 10x).
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Histological findings confirmed the diagnosis of gout (Figure 4).