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Bilateral elbow neurological compression pathology due to mass effect of Gouty tophi

MOJ Orthopedics & Rheumatology
Akshay Lekhi, Ashok Kumar

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Gout is an inflammatory arthritis associated with raised uric acid levels in blood. The pathology involves infiltration and destruction of ligament, cartilage, tendons, bone and skin by deposition of urate crystals. Our purpose of writing this case is to report rare bilateral neurological symptoms due to compression, by tophaceous gout around elbows. A 32-year-old male had presented with episodic tingling in bilateral ulnar nerve distributions for fourteen days. Surgical excision of the tophi around elbows that were causing the neural compression symptoms was done and symptoms relieved gradually over 6 weeks. Tophi are late presentations. They can present with unusual symptoms from depositing at unusual; sites that is evidence sin various literature case reports. Controlling serum uric acid levels below deposition threshold either by dietary or pharmaceutical drugs is the mainstay of management, resulting in dissolution of monosodium urate crystals.