PMC3895757_01
Imaging of gouty joint in an adolescent. (A) Synovitis on MRI with and without IV contrast of the right ankle with osteitis in the distal tibia and talar dome. Talar dome lesion was thought to represent an osteochondritis dissecans/osteonecrosis. (B) Radiographs performed 15 months later show marked joint space loss with persistent talar dome lesion which likely represents an intraosseous tophus.
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F1
Given the lack of response of the patient's ankle to this therapeutic regimen (Figure 1) over the course of the next year, despite improvement in his other joints, arthroscopic exploration of the right ankle with synovectomy and potential OCD curettage was performed.
X-ray imaging of gouty tophus in an adolescent. Lateral view of the forearm shows subcutaneous nodules along the dorsal aspect of the proximal forearm.
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F2
2.5 years after he first presented, the patient developed multiple non-tender scattered subcutaneous nodules over the extensor surface of his bilateral forearms, his left elbow, and his right knee (Figure 2).