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Unusual association of diseases/symptoms
Case report
Bilateral Kienböck’s disease concomitant with gouty arthritis
  1. Deepak Chouhan,
  2. Vivek Shankar and
  3. Mohammed Tahir Ansari
  1. Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Mohammed Tahir Ansari; drtahir.ansari{at}gmail.com

Abstract

A 38-year-old man presented with a 2-month history of pain and stiffness in the bilateral wrist. The pain in right wrist was disabling and severe enough to restrict the daily life activities. After the evaluation of clinical and radiological features, the patient was diagnosed with Kienböck’s disease Lichtman stage IIIB in the right wrist and stage IIIA in the left wrist. Routine laboratory investigations revealed a serum uric acid 9.27 mg/dL. Lunate excision and scaphocapitate fusion were done in the right wrist after discussing with the patient. The histopathological examinations of tophi in synovial tissue were negatively birefringent under polarised light microscopy. It confirmed the diagnoses of gout. Febuxostat was started postoperatively. The patient returned to work at the end of 5 months. There was no recurrence of symptoms and radiological signs of arthritis at the end of 1 year.

  • orthopaedic and trauma surgery
  • rheumatology
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bcr-2019-233725

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    Footnotes

    • Contributors DC wrote the manuscript and provided clinical photographs. VS drafted and revised the manuscript. MTA drafted and wrote the manuscript. MTA performed the surgery. All authors have contributed significantly to the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.