Tophaceous gout of the knee: Revisiting MRI patterns in 30 patients

Kai Hsiung Ko, Yi Chih Hsu, Herng Sheng Lee, Chian Her Lee, Guo Shu Huang

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

OBJECTIVE:: To evaluate the locations and associated erosions of tophaceous gout in the knee and to reevaluate its characteristic magnetic resonance imaging features. MATERIALS AND METHODS:: We performed a retrospective review of the magnetic resonance (MR) images of the knees of 30 patients with histopathologically confirmed gouty tophi. Each tophaceous lesion was evaluated for location, morphology, signal intensity, and associated bone erosion or intraosseous involvement. RESULTS:: The tophaceous masses were commonly located on the medial aspect of the infrapatellar fat pad and anterior joint recess (n = 28, 87%), the space adjacent to the lateral rim of the lateral femoral condyle (n = 25, 78%), and the intercondylar fossae (n = 22, 69%). All tophaceous lesions showed similar signal characteristics (low-intermediate signal intensities on T1-weighted images, with heterogeneous signal intensities on T2-weighted images), and 3 morphologic patterns were observed: amorphous masses (n = 27), linear crystalline-like deposits (n = 6), and cystic lesions of the bursae around the knee (n = 3). Associated bone erosions occurred in the lateral rim of the lateral femoral condyle (n = 8), the roof of the intercondylar notch (n = 7), the tibial eminence (n = 5), and the medial and lateral rim of the tibial plateau (n = 3). Intraosseous tophi were seen in the tibial plateau (n = 3) and patella (n = 1). CONCLUSION:: Knowledge of the common locations and associated erosions of tophaceous gout and its characteristic MR appearance may facilitate its correct diagnosis with magnetic resonance imaging, particularly in patients with no clinical symptom or only an isolated lesion on MR images.

Original languageEnglish
Pages (from-to)209-214
Number of pages6
JournalJournal of Clinical Rheumatology
Volume16
Issue number5
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Gout
Knee
Bone and Bones
Magnetic Resonance Spectroscopy
Thigh
Magnetic Resonance Imaging
Patella
Adipose Tissue
Joints

Keywords

  • knee
  • magnetic resonance imaging
  • tophaceous gout

ASJC Scopus subject areas

  • Rheumatology

Cite this

Tophaceous gout of the knee : Revisiting MRI patterns in 30 patients. / Ko, Kai Hsiung; Hsu, Yi Chih; Lee, Herng Sheng; Lee, Chian Her; Huang, Guo Shu.

In: Journal of Clinical Rheumatology, Vol. 16, No. 5, 08.2010, p. 209-214.

Research output: Contribution to journalArticle

Ko, Kai Hsiung ; Hsu, Yi Chih ; Lee, Herng Sheng ; Lee, Chian Her ; Huang, Guo Shu. / Tophaceous gout of the knee : Revisiting MRI patterns in 30 patients. In: Journal of Clinical Rheumatology. 2010 ; Vol. 16, No. 5. pp. 209-214.
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abstract = "OBJECTIVE:: To evaluate the locations and associated erosions of tophaceous gout in the knee and to reevaluate its characteristic magnetic resonance imaging features. MATERIALS AND METHODS:: We performed a retrospective review of the magnetic resonance (MR) images of the knees of 30 patients with histopathologically confirmed gouty tophi. Each tophaceous lesion was evaluated for location, morphology, signal intensity, and associated bone erosion or intraosseous involvement. RESULTS:: The tophaceous masses were commonly located on the medial aspect of the infrapatellar fat pad and anterior joint recess (n = 28, 87{\%}), the space adjacent to the lateral rim of the lateral femoral condyle (n = 25, 78{\%}), and the intercondylar fossae (n = 22, 69{\%}). All tophaceous lesions showed similar signal characteristics (low-intermediate signal intensities on T1-weighted images, with heterogeneous signal intensities on T2-weighted images), and 3 morphologic patterns were observed: amorphous masses (n = 27), linear crystalline-like deposits (n = 6), and cystic lesions of the bursae around the knee (n = 3). Associated bone erosions occurred in the lateral rim of the lateral femoral condyle (n = 8), the roof of the intercondylar notch (n = 7), the tibial eminence (n = 5), and the medial and lateral rim of the tibial plateau (n = 3). Intraosseous tophi were seen in the tibial plateau (n = 3) and patella (n = 1). CONCLUSION:: Knowledge of the common locations and associated erosions of tophaceous gout and its characteristic MR appearance may facilitate its correct diagnosis with magnetic resonance imaging, particularly in patients with no clinical symptom or only an isolated lesion on MR images.",
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AB - OBJECTIVE:: To evaluate the locations and associated erosions of tophaceous gout in the knee and to reevaluate its characteristic magnetic resonance imaging features. MATERIALS AND METHODS:: We performed a retrospective review of the magnetic resonance (MR) images of the knees of 30 patients with histopathologically confirmed gouty tophi. Each tophaceous lesion was evaluated for location, morphology, signal intensity, and associated bone erosion or intraosseous involvement. RESULTS:: The tophaceous masses were commonly located on the medial aspect of the infrapatellar fat pad and anterior joint recess (n = 28, 87%), the space adjacent to the lateral rim of the lateral femoral condyle (n = 25, 78%), and the intercondylar fossae (n = 22, 69%). All tophaceous lesions showed similar signal characteristics (low-intermediate signal intensities on T1-weighted images, with heterogeneous signal intensities on T2-weighted images), and 3 morphologic patterns were observed: amorphous masses (n = 27), linear crystalline-like deposits (n = 6), and cystic lesions of the bursae around the knee (n = 3). Associated bone erosions occurred in the lateral rim of the lateral femoral condyle (n = 8), the roof of the intercondylar notch (n = 7), the tibial eminence (n = 5), and the medial and lateral rim of the tibial plateau (n = 3). Intraosseous tophi were seen in the tibial plateau (n = 3) and patella (n = 1). CONCLUSION:: Knowledge of the common locations and associated erosions of tophaceous gout and its characteristic MR appearance may facilitate its correct diagnosis with magnetic resonance imaging, particularly in patients with no clinical symptom or only an isolated lesion on MR images.

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