TOPHACEOUS GOUT OF THE WRIST INVOLVING SO FT-TISSUE AND BONE - A RARECAUSE OF A CARPAL-TUNNEL SYNDROME

A 48 year old worker noticed an enlargement of his left wrist, which d eveloped during 1 1/2 years. When numbness of the first three fingers of his left hand occurrecd, a non-invasive diagnostic workup was start ed. Conventional radiography, computed tomography and magnetic resonan ce spectroscopy showed a tumor of a size of 3 x 3 x 2 cm and signs of a past arthritis. Histological examination revealed a gouty tophus. Th e diagnostic surgery induced an acute illness with fever and arthritis of both ankles and the left toe. Therapy with colchicin and diclofena c controlled the gouty attack within three days. The therapy of the to phus included a trial of uricostatic medications for a couple of month s. Eventually the gouty tophus was removed surgically.