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Nonsurgical Treatment of Aseptic Periprosthetic Gout Flare of the Knee

A Report of 2 Cases

Chen, Foster, MD1,a; Glezos, Christopher, MD1,b; Blum, Yossef, MD1,c; Hossack, Michael, MD1,d; Schwechter, Evan M., MD1,e

doi: 10.2106/JBJS.CC.16.00076
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Case: 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.

Conclusion: 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

aE-mail address for F. Chen: Foster.chen.med@gmail.com

bE-mail address for C. Glezos: Cglezos@gmail.com

cE-mail address for Y. Blum: yblum@montefiore.org

dE-mail address for M. Hossack: MIHOSSAC@montefiore.org

eE-mail address for E.M. Schwechter: eschwec@gmail.com

Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated
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