A Patient with Complex Gout with an Autoinflammatory Syndrome and a Sternoclavicular Joint Arthritis as Presenting Symptoms
Joint Authors
Fedeli, M. M.
Vecchi, M.
Rodoni Cassis, P.
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-01-31
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
A 50-year-old man presented to the emergency department with widespread pain, especially at the chest level, fever, and night sweats.
Physical examinations revealed a swelling with localized pain in the left sternoclavicular joint.
Laboratory tests showed a CPR of 134 mg/l and an ESR of 70 mm/h.
The patient’s anamnesis is, for a chronic gouty arthritis, poorly controlled type 2 diabetes and a lumbosacral radicular syndrome.
Home therapy includes metformin, sitagliptin, gliclazide, naproxen with partial benefit on pain, and febuxostat.
Differential diagnoses of sternoclavicular swelling include infection, crystal or psoriatic arthropathy, tumor pathology, SAPHO syndrome, and osteoarthritis.
An ultrasound scan performed at the thoracic level showed the presence of effusion in the sternoclavicular joint.
A thoracoabdominal CT scan, performed in doubt of neoplasias, shows no masses but osteostructural nonspecific alterations of the sternoclavicular joint.
We performed a dual energy CT (DECT) which reports a gouty arthropathy at the sternoclavicular joints (in the literature, only three similar cases are proved).
Because of the poor therapeutic effects using febuxostat and systemic corticosteroids, the patient was treated with anakinra, an interleukin 1 receptor antagonist, which led, 6 months after the event, to a total remission.
American Psychological Association (APA)
Fedeli, M. M.& Vecchi, M.& Rodoni Cassis, P.. 2020. A Patient with Complex Gout with an Autoinflammatory Syndrome and a Sternoclavicular Joint Arthritis as Presenting Symptoms. Case Reports in Rheumatology،Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1151148
Modern Language Association (MLA)
Fedeli, M. M.…[et al.]. A Patient with Complex Gout with an Autoinflammatory Syndrome and a Sternoclavicular Joint Arthritis as Presenting Symptoms. Case Reports in Rheumatology No. 2020 (2020), pp.1-4.
https://search.emarefa.net/detail/BIM-1151148
American Medical Association (AMA)
Fedeli, M. M.& Vecchi, M.& Rodoni Cassis, P.. A Patient with Complex Gout with an Autoinflammatory Syndrome and a Sternoclavicular Joint Arthritis as Presenting Symptoms. Case Reports in Rheumatology. 2020. Vol. 2020, no. 2020, pp.1-4.
https://search.emarefa.net/detail/BIM-1151148
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1151148