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  • Title: [Knee gouty monoarthritis. An arthroscopic view].
    Author: García-Juárez JD, Cuellar-Avaroma A, Tohen-Bienvenu A, Méndez-Tompson M, García-Rosas MS.
    Journal: Acta Ortop Mex; 2013; 27(5):331-4. PubMed ID: 24701775.
    Abstract:
    INTRODUCTION: Gout is the symptom caused by the response to monosodium urate crystals that develop due to hyperuricemia; it is the most frequent inflammatory arthropathy in males over age 40. OBJECTIVE: To demonstrate the diagnosis as an arthroscopic finding. MATERIAL AND METHODS: The case of a male, 39 year-old patient without a relevant medical history whose illness started with left knee trauma consisting of rotation and forced valgus. He initially had pain and inflammation and was treated with immobilization for two weeks. Pain and inflammation persisted so plain films and MRI were ordered and they showed a lesion of the medial meniscus. Arthroscopy of the left knee was performed. RESULTS: The nuclear MRI showed a lesion of the medial meniscus and a chondral lesion of the medial condyle. Preoperative tests showed a uric acid level within the upper normal limit. The arthroscopy showed a transverse lesion of the medial meniscus that was repaired as usual; lesions were found throughout the articular surface, with crystal deposits, as well as an important synovial inflammatory reaction and medial condyle chrondropathy. DISCUSSION: Arthroscopy of a gouty knee shows urate deposits that partially cover the synovial, the anterior cruciate ligament, the menisci and lesion zones in the articular surfaces. Removal of gouty collections and a thorough articular lavage improve the local symptoms of the disease. No synovectomy was performed, as is recommended in the literature.
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