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J Am Acad Orthop Surg, Vol 15, No 10, October 2007, 625-635.
© 2007 the American Academy of Orthopaedic Surgeons
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Gout Affecting the Hand and Wrist

Brian T. Fitzgerald, MD, Arathi Setty, MD and Chaitanya S. Mudgal, MD, MS (Orth), MCh(Orth)

Dr. Fitzgerald is Orthopaedic Surgeon, Naval Medical Center, San Diego, CA. Dr. Setty is Fellow, Rheumatology, Massachusetts General Hospital, Boston, MA. Dr. Mudgal is Instructor, Department of Orthopaedic Surgery, Harvard Medical School; Attending Staff, Orthopaedic Hand Service, Massachusetts General Hospital; and Co-Director, Hand Surgery Fellowship, Boston.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Fitzgerald, Dr. Setty, and Dr. Mudgal.

Reprint requests: Dr. Mudgal, Orthopaedic Hand Service, Massachusetts General Hospital, Suite 2100, Yawkey Center, 55 Fruit Street, Boston, MA 02114.

Tophaceous gout in the hand and wrist often presents de novo as the first sign of the disease process in the elderly. Tophaceous material may present in a liquid, pasty, or chalky/granular state. Treatment may be as simple as aspirating the liquid or squeezing out pasty tophaceous material. Other nonsurgical treatment options include lifestyle and dietary modifications and drug therapy. Surgery is often indicated for the patient with significant tendon and joint compromise as well as skin breakdown and for decompression of compressive peripheral neuropathy.






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Copyright © 2007 by the American Academy of Orthopaedic Surgeons.