INTRAOSSEOUS TOPHACEOUS PSEUDOTUMOR IN THE TRIGONAL PROCESS OF THE TALUS

Primary gout with destructive tophaceous pseudotumor development rarel y occurs in juvenile patients with asymptomatic hyperuricemia. An expa nsile, intraosseous tophaceous pseudotumor on the posterior process of the talus was verified in a 14-year-old boy with posterior ankle impi ngement and asymptomatic hyperuricemia. A review of the literature fou nd no similar cases had been reported, The pathogenesis of this intrao sseous tophaceous pseudotumor on the trigonal process probably was cau sed by the penetration of urate crystals from the periosteum into the posterior process of the talus. However, the time that this intraosseo us tophaceous pseudotumor developed probably was close to the time tha t the second ossification center of the talus fused to the talus. Thus , it cannot be ruled out that the intraosseous tophaceous pseudotumor had formed during the fusion process of the second ossification center as a possible pathogenic mechanism in this unusual case.