A clinical case of a patient with gout complicated by chronic osteomyelitis

• Lekomtsev B.A.
• Mustaev V.R.
• Zagrebin R.K.
• Gorodilova A.S.
• Oleneva S.A.

Abstract

Background. Among the urgent problems of modern medicine, more and more attention is being paid to the high prevalence of the disease among the population suffering from gout. Diagnosis can be made at late stages due to the underestimation of the classic early signs of the disease and the variety of variants of the onset and course of the disease.

Aim. Monitoring the treatment of a patient, including surgical, with gout complicated by chronic osteomyelitis, as well as consideration of modern methods of treatment for this pathology.

Material and methods. We analyzed the medical history of a 55-year-old patient of the City Clinical Hospital No. 6, Izhevsk, with a diagnosis of “Other chronic osteomyelitis”. The data of clinical, laboratory and instrumental examination, therapeutic tactics in relation to patient B. are also analyzed.

Results. In the hospital, patient B. was diagnosed with chronic osteomyelitis after a comprehensive assessment. In addition to drug therapy, the patient underwent surgical rehabilitation of a purulent lesion under local anesthesia with subsequent immobilization. Against the background of complex therapy, there was a significant improvement in the patient’s condition, a decrease in pain syndrome.

Conclusion. This clinical case is unique in that the patient developed post-traumatic chronic osteomyelitis in the form of a purulent surgical complication due to chronic tophaceous gout. In such cases, a comprehensive approach to the treatment of the patient is necessary, which includes both the general aspect and the local aspect of treatment. The presented combination of pathologies is a phenomenal case in purulent surgical practice.

Keywords: gout; chronic osteomyelitis; tophus; urate-lowering therapy; surgical treatment; hyperuricemia

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