A Missed Opportunity: Tophaceous Gout
CGazitt et al represent a missed opportunity case to diagnosis chronic tophaceous gout. Several features of one patient's case belied the original diagnosis. A 70-year-old Filipino man presented to the clinic, complaining of sub- acute worsening of chronic hand pain. Two weeks prior, he experie...
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| Veröffentlicht in: | The American journal of medicine 2015-06, Vol.128 (6), p.571-573 |
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| container_end_page | 573 |
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| container_title | The American journal of medicine |
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| creator | Gazitt, Tal, MD, MSc Thomason, Jenna, MD, MPH Hughes, Grant C., MD |
| description | CGazitt et al represent a missed opportunity case to diagnosis chronic tophaceous gout. Several features of one patient's case belied the original diagnosis. A 70-year-old Filipino man presented to the clinic, complaining of sub- acute worsening of chronic hand pain. Two weeks prior, he experienced increasing pain and swelling of the meta-carpophalangeal joints and both wrists. Over the past several years, he had similar episodes, each lasting 2-3 weeks; shorter when he received oral nonsteroidal anti-inflammatory drugs or prednisone. Between these periods, minimal joint swelling and stiffness remained. Nevertheless, over time, he noted progressive deformity of his meta-carpophalangeal joints. In addition, he reported occasional pain during use of the left shoulder and both knees. He denied fever, chills, rash, or neurologic problems. He had a history of hypertension, chronic renal insufficiency, and remote heavy alcohol use. His only medications were naproxen and acetaminophen. |
| doi_str_mv | 10.1016/j.amjmed.2015.01.039 |
| format | Article |
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Several features of one patient's case belied the original diagnosis. A 70-year-old Filipino man presented to the clinic, complaining of sub- acute worsening of chronic hand pain. Two weeks prior, he experienced increasing pain and swelling of the meta-carpophalangeal joints and both wrists. Over the past several years, he had similar episodes, each lasting 2-3 weeks; shorter when he received oral nonsteroidal anti-inflammatory drugs or prednisone. Between these periods, minimal joint swelling and stiffness remained. Nevertheless, over time, he noted progressive deformity of his meta-carpophalangeal joints. In addition, he reported occasional pain during use of the left shoulder and both knees. He denied fever, chills, rash, or neurologic problems. He had a history of hypertension, chronic renal insufficiency, and remote heavy alcohol use. 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Several features of one patient's case belied the original diagnosis. A 70-year-old Filipino man presented to the clinic, complaining of sub- acute worsening of chronic hand pain. Two weeks prior, he experienced increasing pain and swelling of the meta-carpophalangeal joints and both wrists. Over the past several years, he had similar episodes, each lasting 2-3 weeks; shorter when he received oral nonsteroidal anti-inflammatory drugs or prednisone. Between these periods, minimal joint swelling and stiffness remained. Nevertheless, over time, he noted progressive deformity of his meta-carpophalangeal joints. In addition, he reported occasional pain during use of the left shoulder and both knees. He denied fever, chills, rash, or neurologic problems. He had a history of hypertension, chronic renal insufficiency, and remote heavy alcohol use. His only medications were naproxen and acetaminophen.</description><subject>Aged</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Gout - diagnosis</subject><subject>Gout - pathology</subject><subject>Humans</subject><subject>Interleukin-1 - antagonists & inhibitors</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical treatment</subject><subject>Rheumatism</subject><subject>Risk Factors</subject><issn>0002-9343</issn><issn>1555-7162</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFq3DAQhkVoSLZp3qCUhVLoxc6MZFlWD4EQ0iSQkEOTs9DKYyrXa7uSXdi3j8wmFHLJSQh9M5r_G8Y-I-QIWJ61ud22W6pzDihzwByEPmArlFJmCkv-ga0AgGdaFOKYfYyxTVfQsjxix1yqQmFVrdi3i_W9j5Hq9cM4DmGaez_tfqwfh_G3dTTMcX09zNMndtjYLtLpy3nCnn5ePV7eZHcP17eXF3eZKwo5ZZqkhcaiUk6AcFRWWEkS2ioJtFFUVJbrCjbWVhpLqAU2WkEjayWIo3DihH3f9x3D8HemOJmtj466zvbLLAbLSgipuNIJ_foGbYc59Gm6ROmUFLmWiSr2lAtDjIEaMwa_tWFnEMyi0bRmr9EsGg2gSRpT2ZeX5vNmeXstevWWgPM9QMnGP0_BROepd1T7QG4y9eDf--FtA9f53jvb_aEdxf9ZTOQGzK9llcsmUaZkqijFM38hlrQ</recordid><startdate>20150601</startdate><enddate>20150601</enddate><creator>Gazitt, Tal, MD, MSc</creator><creator>Thomason, Jenna, MD, MPH</creator><creator>Hughes, Grant C., MD</creator><general>Elsevier Inc</general><general>Elsevier Sequoia S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20150601</creationdate><title>A Missed Opportunity: Tophaceous Gout</title><author>Gazitt, Tal, MD, MSc ; Thomason, Jenna, MD, MPH ; Hughes, Grant C., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-9e5a0fa177c303ce68185e39a750eb7e48a2980baa89160d31f970f5d73e213c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Gout - diagnosis</topic><topic>Gout - pathology</topic><topic>Humans</topic><topic>Interleukin-1 - antagonists & inhibitors</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical treatment</topic><topic>Rheumatism</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gazitt, Tal, MD, MSc</creatorcontrib><creatorcontrib>Thomason, Jenna, MD, MPH</creatorcontrib><creatorcontrib>Hughes, Grant C., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gazitt, Tal, MD, MSc</au><au>Thomason, Jenna, MD, MPH</au><au>Hughes, Grant C., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Missed Opportunity: Tophaceous Gout</atitle><jtitle>The American journal of medicine</jtitle><addtitle>Am J Med</addtitle><date>2015-06-01</date><risdate>2015</risdate><volume>128</volume><issue>6</issue><spage>571</spage><epage>573</epage><pages>571-573</pages><issn>0002-9343</issn><eissn>1555-7162</eissn><coden>AJMEAZ</coden><abstract>CGazitt et al represent a missed opportunity case to diagnosis chronic tophaceous gout. Several features of one patient's case belied the original diagnosis. A 70-year-old Filipino man presented to the clinic, complaining of sub- acute worsening of chronic hand pain. Two weeks prior, he experienced increasing pain and swelling of the meta-carpophalangeal joints and both wrists. Over the past several years, he had similar episodes, each lasting 2-3 weeks; shorter when he received oral nonsteroidal anti-inflammatory drugs or prednisone. Between these periods, minimal joint swelling and stiffness remained. Nevertheless, over time, he noted progressive deformity of his meta-carpophalangeal joints. In addition, he reported occasional pain during use of the left shoulder and both knees. He denied fever, chills, rash, or neurologic problems. He had a history of hypertension, chronic renal insufficiency, and remote heavy alcohol use. His only medications were naproxen and acetaminophen.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25747188</pmid><doi>10.1016/j.amjmed.2015.01.039</doi><tpages>3</tpages></addata></record> |
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| issn | 0002-9343 1555-7162 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Aged Glucocorticoids - therapeutic use Gout - diagnosis Gout - pathology Humans Interleukin-1 - antagonists & inhibitors Internal Medicine Male Medical diagnosis Medical treatment Rheumatism Risk Factors |
| title | A Missed Opportunity: Tophaceous Gout |
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