CASE REPORT OF GOUT ARTHRITIS IN THE JOINTS OF THE FINGERS AND LITERATURE REVIEW

Abstract

Gout is the most common inflammatory arthritis, occurring when hyperuricaemia, a sustained elevation of serum urate levels resulting in supersaturation of body tissues with urate, leads to the formation and deposition of monosodium urate crystals in and around the joints. Range from a prevalence of <1% to 6,8% and incidence of 0,58-2,89 per 1000 person years. Gout is more prevalent in men than in women, particularly with increasing age, and in certain ethnic groups. A 49-year-old man came for treatment at a private hospital in Medan complaining of a bump, hemorrhage, and pain in the big toe on the left side, experienced for 1 month. Patient had a history of hypertension, gout arthtritis and cardiac arteriosclerotic diseases (CAD). Then, the patient was referred to the orthopaedic department, where he was diagnosed with gout arthritis and recommended for hospitalization. After that, the surgery and histopathological examination of that specimen in the Laboratory of Anatomical Pathology. A one-piece mass with yellowish grey colour, friable consistency, and dimensions of 5 x 4 x 3 cm was received. Microscopic examination showed that it consists of partly muscle tissue; in some places, a gouty deposit is seen, surrounded by fibrous connective tissue and a mononuclear inflammatory cell infiltrate. Locally found histiocytes and giant cells. No sign of malignancy was found in this preparation. Based on clinical data manifestation, laboratory results, macroscopic and microscopic examinations, this patient was diagnosed with gouty arthritis.