title: Carpal tunnel syndrome caused by tophaceous gout: CT and MR imaging features in 20 patients.
abstract: OBJECTIVE
  The objective of this study is to describe the CT and MR imaging findings of gouty tophi in the wrist and present this entity as a cause of carpal tunnel syndrome.
  
  
  METHODS
  Retrospective review of the CT (n = 18) and MR imaging (n = 20) studies of the wrist in patients with a documented diagnosis of gout who presented with gout-related carpal tunnel syndrome was performed; images of 24 wrists were collected over a 5-year period. Patient population included 20 men, who ranged in age from 35 to 76 years. All images were reviewed by two musculoskeletal radiologists who reached a consensus opinion. Surgical correlation was available in 12 patients.
  
  
  RESULTS
  Tophi were found in the floor of the carpal tunnel (n = 18), carpal bones (n = 17), radiocarpal joint (n = 17), and extensor tendons or tendon sheaths (n = 16) of the wrist. All tophi showed similar signal characteristics (from low to intermediate signal intensity on T1-weighted images with heterogeneous signal intensity on T2-weighted images) with the exception of tophi in the floor of the carpal tunnel (low signal intensity on T2-weighted images). Varying degrees of calcification were noted on CT and MR imaging studies. Gadolinium-enhanced MR studies showed heterogeneous enhancement.
  
  
  CONCLUSIONS
  Gouty tophi should be entertained as a cause of carpal tunnel syndrome in the appropriate patient population. Familiarity with this entity and its imaging characteristics may prove helpful in diagnosis and preoperative planning.
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd. Kaohsiung, 813 Taiwan.
authors.forename: C K
authors.initials: CK
authors.lastname: Chen
authors.forename: C B
authors.initials: CB
authors.lastname: Chung
authors.forename: L
authors.initials: L
authors.lastname: Yeh
authors.forename: H B
authors.initials: HB
authors.lastname: Pan
authors.forename: C F
authors.initials: CF
authors.lastname: Yang
authors.forename: P H
authors.initials: PH
authors.lastname: Lai
authors.forename: H L
authors.initials: HL
authors.lastname: Liang
authors.forename: D
authors.initials: D
authors.lastname: Resnick
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006073:Gout / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014527:Uric Acid
chemical_list: D014527:Uric Acid