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Gout Patellar Erosion Angio

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<v ->And the other case I'm gonna show you is this one.

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This is a 65 year old female with knee pain,

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anterior knee pain.

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So I usually start immediately looking at the meniscus,

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the cruciate and this calls my attention,

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a little high signal on this ACL here, normal PCL.

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Call my attention also high signal of this fat pad

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adjacent to the quadricep tendon that little bit enlarged.

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And calls my attention also when I look this coronal image

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a high signal here of the popliteus tendon

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that can be confirmed when we look here on the axle

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for this popliteus tendon.

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So something is going on in this knee here

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and it's not very, it's something subtle

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that we can have some involvement of ACL,

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the soft tissue at the suprapatellar recess

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and at insertion of the popliteus tendon.

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We can see with a little bit more detail here,

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that we have an erosion on the patella here.

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So this is a classic place for the erosion of gout.

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And we on daily exams, I am sure we don't do this diagnosis.

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We don't call this diagnosis as much as we should.

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And there are many gout patients

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that presents with subtle findings.

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So when you see a edema of the ACL with no traumatic injury,

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edema and the tendinopathy of the popliteus tendon,

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we should think about gout.

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We did also that helped on this case,

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we did also angiogram and post contrast.

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See, this is the post contrast showing the enhancement here.

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Suprapatellar fat pad.

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And with the angle, we could see the inflammatory process

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at that site and also inflammatory process

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at the insertion of the popliteus tendon.

Report

Faculty

Donald Resnick, MD

Professor Emeritus, Department of Radiology

University of California, San Diego

Carlos H. Longo, MD

Head of Radiology

Hospital Beneficência Portuguesa de São Paulo

Abdalla Skaf, MD

Head of the Department of Diagnostic Imaging Hospital HCor / Medical director of ALTA diagnostics (DASA group)

HCOR / DASA / TELEIMAGEM

Rodrigo Aguiar, MD, PhD

Professor of Radiology

Federal University of Paraná - Brazil

Marcelo D’Abreu, MD

Head of Radiology

Hospital Mae de Deus

Tags

X-Ray (Plain Films)

Musculoskeletal (MSK)

MSK

MRI

Knee

CT