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Semin Musculoskelet Radiol 2025; 29(01): 134-138
DOI: 10.1055/s-0044-1800845
Didactic Case Report

Tophaceous Gout Mimicking a Neoplasm of the Patella

Gwendolyn Vuurberg 
1   Department of Imaging, Radboud University Medical Centre, Nijmegen, the Netherlands
2   Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, the Netherlands
,
Jacky W.J. de Rooy
1   Department of Imaging, Radboud University Medical Centre, Nijmegen, the Netherlands
,
Filip M. Vanhoenacker
3   Faculty of Medicine, KU Leuven, Leuven, Belgium
4   Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
5   Department of Diagnostic Sciences, UZ Gent, Faculty of Medicine and Health Sciences, Ghent, Belgium
6   Department of Radiology, UZ Antwerpen, Faculty of Medicine and Health Sciences University of Antwerp, Edegem, Belgium
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Abstract

Tophaceous gout of the patella and extensor apparatus of the knee can mimic a musculoskeletal neoplasm. Considering gout, correlation with clinical history and presentation, and meticulous analysis of imaging semiology are key to a correct diagnosis. The most useful signs are periarticular erosion with overhanging edges, increased soft tissue on radiography and computed tomography, the “snowstorm sign” on ultrasound, variable signal and enhancement, bandlike infiltration of tendons, and osseous erosions with no or little bone marrow edema on magnetic resonance imaging. Dual-energy computed tomography is both a sensitive and specific tool for noninvasive characterization of gout and for differentiating other crystal arthropathies.

Keywords

tophaceous gout - pseudotumor - radiography - dual-energy computed tomography - magnetic resonance imaging


Publication History

Article published online:
11 February 2025

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