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Pseudotumor of gout in the patella of a kidney transplant recipient

Nature Clinical Practice Nephrology volume 3, pages 345–349 (2007)Cite this article

Abstract

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.

Investigations 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.

Diagnosis Pseudotumor of gout in the patella.

Management 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.

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Figure 1: Radiographic images of the right knee
Figure 2: Arthroscopic views of the right knee joint
Figure 3: Histology of the patella biopsy specimen

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Authors and Affiliations

  1. T Staub-Zähner is a Nephrologist, C Fretz is Head of Magnetic Resonance Imaging, C Lampert is an Orthopedic Surgeon, and C Öhlschlegel is a Consultant Surgical Pathologist, all at Kantonsspital, St Gallen, Switzerland.,

    Tanja Staub-Zähner, Christian Fretz, Christoph Lampert & Christian Öhlschlegel

  2. D Garzoni is a Nephrologist at University Hospital Basel, Switzerland.,

    Daniela Garzoni

  3. RP Wüthrich is the Director and T Fehr is an Attending Physician, both in the Clinic for Nephrology at University Hospital, Zurich, Switzerland.,

    Rudolf P Wüthrich & Thomas Fehr

Authors
  1. Tanja Staub-Zähner
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  2. Daniela Garzoni
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  3. Christian Fretz
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  4. Christoph Lampert
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  5. Christian Öhlschlegel
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  6. Rudolf P Wüthrich
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  7. Thomas Fehr
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Corresponding author

Correspondence to Thomas Fehr.

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The authors declare no competing financial interests.

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Staub-Zähner, T., Garzoni, D., Fretz, C. et al. Pseudotumor of gout in the patella of a kidney transplant recipient. Nat Rev Nephrol 3, 345–349 (2007). https://doi.org/10.1038/ncpneph0494

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