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Case Reports in Orthopedics
Volume 2017 (2017), Article ID 7201312, 4 pages
Case Report

Multiple Tophaceous Gout of Hand with Extensor Tendon Rupture

1Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan
2Department of Surgical Pathology, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan

Correspondence should be addressed to Masanori Nakayama

Received 19 June 2017; Revised 11 November 2017; Accepted 20 November 2017; Published 20 December 2017

Academic Editor: George Mouzopoulos

Copyright © 2017 Haruki Tobimatsu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 45-year-old man presented with painless subcutaneous masses bilaterally on his hands and loss of motion or contracture of the fingers. Initially, drug therapy to reduce the serum uric acid was administered and was expected to reduce the tophi. However, during observation at the clinic, spontaneous rupture of an extensor tendon occurred, and surgical repair of the tendon and resection of the masses were performed. Surgical exploration of the right hand showed hypertrophic white-colored crystal deposits that both surrounded and invaded the extensor digitorum communis of the index finger, which was ruptured. Histopathologic examination of the specimen demonstrated findings consistent with gouty tophi. Tophaceous gout can induce a rupture of tendons during clinical observation, and surgical resection of the tophi might be needed to prevent ruptures.