Case Report

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome following spontaneous rupture of a gouty tophus

Authors

Kota Sugisaki¹ and Taro Hirose²

1. Division of Rheumatology, Jusendo General Hospital, 1-8-16 Ekimae, Koriyama Fukushima, 963-8585, Japan
2. Division of Plastic and Reconstructive Surgery, Jusendo General Hospital, Koriyama, Fukushima, Japan

Received:

1 May 2008

Accepted:

24 June 2008

Published online:

8 August 2008

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Abstract

A 70-year-old man with a 30-year history of gout presented with a ruptured gouty tophus over the right lateral malleolus. After the debridement of the tophus, bilateral arthralgia and pitting edema were observed in his extremities. Treatments with antibiotics and nonsteroidal antiinflammatory drugs were ineffective. However, prednisolone therapy was highly effective, and the patient’s symptoms were rapidly ameliorated. Thus, we presume that rupture of a gouty tophus or its surgical treatment might contribute to the occurrence of RS3PE syndrome; however, in our case, the etiology of the syndrome remained unknown.

Key words

Debridement - Gout - Remitting seronegative symmetrical synovitis with pitting edema syndrome - Tophus rupture