A case of tophaceous gout of the navicular bone in a 24-year-old woman is reported. Emphasis is placed on the conditions that might have been precipitating, i.e., anorexia nervosa and alcoholism, and the mechanisms by which increased uric acid level may be explained. The main radiographic patterns of tophaceous gout of the foot are recalled to avoid unnecessary surgery in future cases.
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References
1.
. GuptaM. A.Kavanaugh DanelonD.: Elevated serum uric acid in eating disorders a possible index of strenuous physical activity and starvation. Int. J. Eat. Disord., 8: 463–472, 1989.
2.
. HayemG.DelahousseM.MeyerO.PalazzoE.ChazerainP.KahnM. F.: Female premenopausal tophaceous gout induced by longterm diuretic abuse. J. Rheumatol., 23: 2166–2167, 1996.
3.
. HillL. M.: Subject review: metabolism of uric acid in normal and toxemic pregnancy. Mayo Clin. Proc., 53: 743–749, 1978.
4.
. HollingworthP.ScottJ. T.BurryH. C.: Non articular gout: hyperuricemia and tophus without gouty arthritis. Arthritis Rheum., 26: 98–10, 1983.
5.
. LieberC. S.DavidsonC. S.: Some metabolic effects of ethanol accumulation. Am. J. Med., 33: 319–327, 1962.
6.
. MairS. D.CooganA. C.SpeerK. P.HallR. G.: Gout as a source of sesamoid pain. Foot Ankle, 16: 613–616, 1995.
7.
. O'SullivanJ. B.: Gout in a New England town. Ann. Rheum. Dis., 31: 166–169, 1972.
8.
. PuigJ. G.MichanA. D.JimenezM. L. et al.: Female gout: Clinical spectrum and uric acid metabolism. Arch. Intern. Med., 151: 726–732, 1991.
9.
. ResnickD.NawayamaG.: Diagnosis of Bone and Joint Disorders. Philadelphia, W. B. Saunders Company, 1981, pp. 1463.
10.
. ThomasE.LerouxJ. L.SerreI.BonnelF.MaryH.BaldetP.BlotmanF.: Tophaceous gout of the patella with primary hyperparathyroidism. Clin. Exp. Rheumatol., 13: 263–265, 1995.
11.
. WolfsonW. Q.HuntH. D.LevineR. et al.: The transport and excretion of uric acid in man: a sex difference in urate metabolism. J. Clin. Endocrinol., 9: 749–767, 1949.
12.
. WyngaardenJ. B.KelleyW. N.: Gout and Hyperuricemia. New York, Grune 8#x38; Stratton, 1976, pp. 369–380.