Author/Editor		Markota, Jelena
Title		Unusual radiographic changes of a gout patient
Translated title		Nenavadne radiografske spremembe pri bolnici s putiko
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 38, št. 4
Publication year		2004
Volume		str. 349-52
Language		eng
Abstract		Background. Gout is a metabolic disorder that results in hyperuricemia and accumulation of uric acid crystals (urats) in tissues, especially joint cortilage. The gouty arthritis presents as acute attacks of arthritis leading eventually to chronic gouty arthritis. In 80% of cases it first occurs in the matatarsophalangeal (MTP) joint of the great toe and is more frequent in mnle population. Case report. We present a case of unusual radiographic changes accompanying gouhy arthritis. A 63 year old female complained about swelling of the first MTP joint on the right, right knee, about stiffness of feet and hands' digits and about backache. First symptoms started to appear 30 years ago. In the time of examination radiographs displayed degenerative changes of the majority of presented joints, bilateral sacroiliitis and osseous ankylosis of both insteps. Microscopic examination showed urate crystals in the samples of the synovial fluid aspirated from the knee. The histological findings of the synovial tissue after the synovectomy were also in favour of gouty arthritis. Conclusions. Radiographs are the most irnportant imaging modality in the diagnostic process of gout. However, radiographic differential diagnosis can be difficult, since the findings overlap with other conditions which cause arthritis and osteoarthritis especially in longstanding gout, elderly patients and females. The diagnosis must be often confirmed with the help of Inboratory and histological findings.
Summary		Izhodišča. Putika je metabolna motnja, ki je povezana s hiperurikemijo in nalaganjem kristalov sečne kisline (uratov) v tkiva, zlasti v sklepni hrustanec. Za urični artritis so značilni ponavljajoči se napadi akutnega artritisa, ki se lahko nadaljuje v kronično obliko. V 80% primerov se bolezen začne v metatarzofalangealnem sklepu nožnega palca in je pogostejša pri moških. Prikaz primera. Prikazali smo primer nenavadnih radiografskih sprememb pri uričnem artritisu. 63-letna bolnica se je pritoževala nad občasnim otekanjem bazalnega sklepa desnega nožnega palca in desnega kolena, okorelostjo stopal in prstov rok ter bolečinami v hrbtu. Prve težave so se pojavile pred tridesetimi leti. Rentgenogrami so pokazali degenerativne spremembe večine slikanih sklepov, obojestranski sakroiliitis in kostno ankilozo obeh nartov. Pri pregledu sinovijske tekočine kolena s polarizacijskim mikroskopom so ugotovili uratne kristale. Tudi histološki izvid sinovije po sinovektomiji je potrdil urični artritis. Zaključki. Radiografija je najpomembnejša slikovna metoda pri diagnostiki putike. Diferencialna diagnostika pa je lahko težavna, kadar se spremembe prekrivajo z drugimi artritisi ali osteoartrozo, zlasti pri dolgotrajni putiki, starejših bolnikih in ženskah. V teh primerih končno diagnozo potrdimo z laboratorijskimi in histološkimi izvidi.
Descriptors		ARTHRITIS, GOUTY KNEE JOINT ANKLE JOINT SACROILIAC JOINT MIDDLE AGE