Sandeep K R
Pariyaram Medical College, India
Sandeep K R is an associate professor at Pariyaram Medical College, India.
Tophi are the deposits of monosodium urate crystals in joints and soft tissues. It is pathognomonic of gout. Gout can be a diagnostic challenge if it presents with intraosseous tophus deposits with normal serum uric acid levels. We report an unusual case of intraosseous tophus deposits presenting with symptoms of posterior ankle impingement syndrome. The patient had normal serum uric acid levels with no previous history of gout. Imaging studies showed elongated talar process, based on which the diagnosis of posterior ankle impingement was confirmed. The patient underwent endoscopic resection after the failure of conservative management. The Hind-foot endoscopy revealed chalky white deposits in and around the talar process. The histopathological report confirmed the deposits to be tophaceous gout. To the best of our knowledge, this is the first reported case of gout presenting with the interosseous deposits with normal serum uric acid levels.