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Case Reports
. 2023 Feb 1;10(1):100065.
doi: 10.1016/j.acpath.2022.100065. eCollection 2023 Jan-Mar.

Educational Case: Gout

Jonathan Light  1 , Laurie L Wellman  1   2 , Richard M Conran  1   2
Affiliations
Case Reports

Educational Case: Gout

Jonathan Light et al. Acad Pathol. .
No abstract available

Keywords: Arthritis; Gout; Musculoskeletal; Non-neoplastic disorders; Organ system pathology; Pathology competencies; Podagra; Tophus.

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Figures

Fig. 1
Fig. 1
First metatarsophalangeal joint of the big toe. The image shows enlargement, with associated erythema, of the first metatarsophalangeal joint.
Fig. 2
Fig. 2
Synovial fluid. Yellow, needle-shaped negatively birefringent crystals consistent with uric acid are present under polarized light on a red plate (blue plus sign). The yellow arrow indicates crystals that are parallel to the main axis of the red compensator. These parallel crystals appear yellow, whereas those crystals perpendicular to the polarized light appear blue (blue arrow). Republished from webpath at https://webpath.med.utah.edu/HISTHTML/STAINS/STAIN004.html with permission from Edward Klatt, MD. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Fig. 3
Fig. 3
Osteoarthritis. The gross image of the femoral head demonstrates the erosion of the articular surface (arrowhead) with a subchondral cyst (red arrow). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
Fig. 4
Fig. 4
Osteoarthritis. Fragmented articular surface in osteoarthritis. The articular surface of the bone in this image shows fragmentation of the articular surface, referred to as “fibrillation.” (H&E, intermediate magnification).
Fig. 5
Fig. 5
Rheumatoid arthritis. The hyperplastic synovium shows numerous finger-like villous projection that replaced the joint space.
Fig. 6
Fig. 6
Rheumatoid arthritis. The synovium shows hyperplasia with villous formation (arrows). Lymphoid aggregates are seen in the villi (arrowheads). (H&E, low magnification).
Fig. 7
Fig. 7
Gouty tophus. A low-power image shows the pale staining deposits of dissolved urate crystals (∗), surrounded by fibroblasts and mononuclear inflammatory cells. (H&E, low magnification).
Fig. 8
Fig. 8
Gouty tophus. A. Dissolved urate crystals are rimmed by mononuclear inflammatory cells, fibroblasts, and giant cells. B. Higher magnification shows the large number of giant cells surrounding the urate crystals. (H&E, intermediate magnification).
See this image and copyright information in PMC

References

    1. Knollmann-Ritschel B.E.C., Regula D.P., Borowitz M.J., Conran R., Prystowsky M.B. Pathology Competencies for medical Education and Educational cases. Acad Pathol. 2017;4 doi: 10.1177/2374289517715040. - DOI - PMC - PubMed
    1. Margaretten M.E., Kohlwes J., Moore D., Bent S. Does this adult patient have septic arthritis? J Am Med Assoc. 2007;297(13):1478–1488. doi: 10.1001/jama.297.13.1478. - DOI - PubMed
    1. Gottlieb M., Holladay D., Rice M. Current approach to the evaluation and management of septic arthritis. Pediatr Emerg Care. 2019;35(7):509–515. doi: 10.1097/PEC.0000000000001874. - DOI - PubMed
    1. Sanford S. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. first ed. Roberts J., Custalow C., Thomsen T., editors. Elsevier; 2019. Arthrocentesis; pp. 1105–1124.
    1. Momodu, Savaliya V. StatPearls; 2021. Septic Arthritis.https://www.ncbi.nlm.nih.gov/books/NBK538176/ - PubMed

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