Gout is a rarely reported cause of a painful knee following total knee arthroplasty, but it can mimic infection in its symptomatology and workup. Two individuals who had previously undergone a knee replacement and had a history of gout had symptoms of infection. These patients presented with knee warmth and effusion, and they had elevated inflammatory markers and synovial cell counts. In both cases, there was a good response to medication, and surgery was avoided.
Although simultaneous infection can occur, aseptic periprosthetic gout should be considered in individuals with a known history of gout, in those with a good response to anti-gout medication, and when there is an otherwise negative workup for infection.
1Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York
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