Pseudotumor of gout in the patella of a kidney transplant recipient.
BACKGROUND
A 33-year-old renal transplant recipient presented with painless swelling of the right knee. Physical examination revealed an impressive knee joint effusion with no signs of inflammation. The patient did not remember a recent trauma, but he mentioned a strain 3 years earlier; radiographic findings had been normal at that time. The patient had suffered from end-stage renal disease due to chronic glomerulonephritis and had previously undergone two transplantations. At presentation, his kidney function was stable under treatment with ciclosporin, azathioprine and steroids.


METHODS
Conventional radiography revealed a tumor at the superolateral pole of the right patella. Extensive soft tissue invasion and bone destruction was seen on MRI. A knee arthroscopy with biopsy, performed to aid diagnosis, showed extensive chondrocalcinosis macroscopically; histologically, gouty tophi were found.


METHODS
Pseudotumor of gout in the patella.


RESULTS
Uric-acid-lowering therapy with benzbromarone was started immediately after diagnosis. A local arthroscopic debridement of the right knee joint was performed 4 months later, and the patient remained asymptomatic for the next 3 years.
Staub-Zähner
Tanja
T
Kantonsspital, St Gallen, Switzerland.
Garzoni
Daniela
D
Fretz
Christian
C
Lampert
Christoph
C
Ohlschlegel
Christian
C
Wüthrich
Rudolf P
RP
Fehr
Thomas
T
D000328:Adult; D006073:Gout / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010329:Patella