Acute Gout Following Dermofasciectomy in a Patient With Dupuytren Disease.
A 62-year-old man underwent uncomplicated dermofasciectomy of the right little finger. In the week after surgery, he presented with erythema, tenderness, reduced range of movement, and a chalklike discharge from the suture line. Investigations revealed a raised serum urate level accompanied with a borderline rise in inflammatory markers. A diagnosis of acute gout was made. The patient was managed with nonsteroidal anti-inflammatory drugs. Clinicians should consider the diagnosis of gout when patients present after surgery with redness, pain, and swelling and also consider measuring urate levels before surgery and initiating colchicine prophylaxis when there is a known diagnosis of gout before surgery. Accurate diagnosis may prevent unnecessary antibiotic use.
Sheffield Hand Unit, Northern General Hospital, Sheffield, United Kingdom. Electronic address: elliottcochrane@doctors.org.uk.
Elliott
E
Cochrane
Sheffield Hand Unit, Northern General Hospital, Sheffield, United Kingdom.
Rosalyn
R
Harper
D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004387:Dupuytren Contracture / Q000601:surgery*; D000071938:Fasciotomy / Q000009:adverse effects* / Q000379:methods; D005385:Fingers / Q000601:surgery; D006073:Gout / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014527:Uric Acid / Q000032:analysis / Q000097:blood
D000894:Anti-Inflammatory Agents, Non-Steroidal; D014527:Uric Acid
Dermofasciectomy; Dupuytren; Gout