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Musculoskeletal & Skin Pathology for Medical II Students Spring 2008 Lab Supplement Arthritis 8 Case History Chronic Gout Arthritis Slide 22: A 28-year-old salesman began to have attacks of migratory polyarthritis at the age of 21. The onset was sudden without preceding infection or prodromata. The attacks were characterized by marked swelling, redness and pain of the affected joints. At first the remissions were complete and lasted about one year. Gradually, however, increasing residual stiffness and deformity developed in the involved joints. Tophi were noted in one ear, a terminal finger joint and an olecranon bursa. Roentgenologic examination showed extensive joint changes including irregularity of the articular surfaces, narrowing of joint spaces, partial dislocation, ankylosis, and hypertrophic changes. Punched out areas of rarefaction were present in the articular ends of several phalanges and of one os calcis. The fasting blood uric acid was 9.4 mg per dl. (Normal 4.0 - 8.4 mg per dl). The head of the proximal phalanx of the third finger was amputated to correct a hyperextension deformity. Case History Alkaptonuria (Ochronosis) Slide 23: The patient was a 58-year-old white man who died of congestive heart failure. He had a long history of arthritis affecting many joints, particularly the knees. The urine was dark brown. The sclerae were discolored brown. At autopsy, tendons, cartilage, endocardium, atheromatous plaques and kidneys were seen to be pigmented black. Villous synovitis was present in both knees. Slides 22 & 23 Arthritis home | a.1 | a.2 | a.3 | a.4 | a.5 | a.6 | a.7 | a.8 Updated August 29, 2007
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