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Gouty tenosynovitis in the hand
Authors:J R Moore  A J Weiland
Affiliation:From The Johns Hopkins University School of Medicine, Department of Orthopaedic Surgery, Baltimore, Md.
Abstract:Gouty tenosynovitis can present as an infection, tendon rupture, nerve compression, or digital stiffness. In ten patients, extensive urate deposition was encountered in the extensor tendons at both the wrist and digital levels in addition to involvement of the flexor tendons in the carpal canal and digital theca. Direct nerve or muscle involvement was not observed in the hand. Medical therapy, which is now the cornerstone of treatment for most aspects of gout, may not be the best treatment for tophaceous deposits in the hand. Operative treatment may be required to debulk tophaceous deposits, improve tendon gliding, decompress nerves, allow increased range of motion of joints, and ameliorate pain.
Keywords:Reprint requests: J. Russell Moore   M.D.   Assistant Professor of Orthopaedic Surgery   The Good Samaritan Professional Office Bldg.   5601 Loch Raven Blvd.   Baltimore   MD 21239.
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