CASE REPORT
Gouty flexor tenosynovitis of the hand mimicking atypical mycobacterial infection
Yoshiki Yoshihara1, 4 , Tomayoshi Hayashi3, Seiji Matsushita1, Hideki Sugita1 and Hiroshi Miki2
| (1) |
Department of Orthopaedic Surgery, Sakaide Municipal Hospital, 1-6-43 Bunkyo, Sakaide 762-0031, Japan |
| (2) |
Department of Pathology, Sakaide Municipal Hospital, Sakaide, Japan |
| (3) |
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan |
| (4) |
Present address: Department of Orthopedic Surgery and Rheumatology, Kurashiki Medical Center, 250 Bakuro-cho, Kurashiki 710-8522, Japan |
Received: 11 April 2005 Accepted: 29 July 2005
Abstract A 50-year-old Japanese fish dealer presented with painful and swollen fingers. Infectious flexor tenosynovitis with Mycobacterium marinum was suspected. Range of motion was restored after tenosynovectomy and after ofloxacin and clarithromycin were administered. Two years after the operation, the patient presented again with acute inflammation in the same fingers. Histopathological examination revealed gouty tenosynovitis. The preconception that mycobacterial infection occurs often in fish dealers caused us to miss the correct diagnosis of gouty tenosynovitis.
Key words Gout - Hand - Tenosynovitis - Tophus - Urate crystal
