Gouty arthritis is a type of metabolic disease in which sodium urate crystals are deposited in the bone and joints, causing local inflammatory reactions and destruction of the bone tissue. Gouty arthritis involving the large joints of the upper extremities is rare in clinical practice. This study aimed to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of gouty arthritis primarily involving the large joints of the upper limbs, signal or density characteristics of the tophi, growth patterns, involvement of the adjacent joints, and differentiation from other lesions occurring in this area and to discuss the causes of misdiagnosis.
CT and MRI data were collected from 14 patients with gouty arthritis, primarily involving the shoulder and elbow joints, and their imaging features were analyzed.
14 patients were aged between 28 and 85 years,All patients demonstrated nodular or mass-like abnormal signal shadows on CT, with equal or slightly long signals on T1-weighted image (WI) and short or slightly long signals on T2WI in the MRI. All 14 patients revealed narrowing of the affected joint space, with bone resorption and erosion under the joint surface of the larger tophis. The tophis grew around the joint, with anterolateral and posterolateral tophis observed predominantly in the shoulder joint, and dorsal tophis observed predominantly in the elbow joint on the MRI, with compression and edema of the surrounding soft tissues.
We analyzed patients with gouty arthritis involving the large joints of the upper extremities and observed an increased prevalence in young and middle-aged men who may have had clear tophi in the past.