Images in Clinical Rheumatology
Gout Mimicking Soft Tissue Tumor
Gota que simula tumoración de partes blandas
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B) Estudio con microscopio óptico que detectó cristales de urato monosódico con forma de aguja en el interior de la tumoración.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Diego Páez Granda, María Dolores Abellán Rivero, Angela Cepero Calvache, Nuria Lozano Rivas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Diego" "apellidos" => "Páez Granda" ] 1 => array:2 [ "nombre" => "María Dolores" "apellidos" => "Abellán Rivero" ] 2 => array:2 [ "nombre" => "Angela" "apellidos" => "Cepero Calvache" ] 3 => array:2 [ "nombre" => "Nuria" "apellidos" => "Lozano Rivas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574318301618" "doi" => "10.1016/j.reumae.2018.11.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301618?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X17302012?idApp=UINPBA00004M" "url" => "/1699258X/0000001500000006/v1_201911200727/S1699258X17302012/v1_201911200727/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173574318301576" "issn" => "21735743" "doi" => "10.1016/j.reumae.2018.11.002" "estado" => "S300" "fechaPublicacion" => "2019-11-01" "aid" => "1109" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2019;15:e149-e150" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Carpal Tunnel Syndrome Due to a Tophus: Low-field Magnetic Resonance Image" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e149" "paginaFinal" => "e150" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome del túnel del carpo por tofo: imagen de resonancia magnética de bajo campo" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 431 "Ancho" => 1500 "Tamanyo" => 85243 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Axial T1; (B) Axial STIR; (C) Sagittal STIR. Arrows: T1 hypointense material with increased signal in STIR, within the sheath of the carpal flexor tendon level.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Dolores Ruiz Montesino, Dolores Mendoza Mendoza" "autores" => array:2 [ 0 => array:2 [ "nombre" => "María Dolores" "apellidos" => "Ruiz Montesino" ] 1 => array:2 [ "nombre" => "Dolores" "apellidos" => "Mendoza Mendoza" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X17301973" "doi" => "10.1016/j.reuma.2017.07.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X17301973?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301576?idApp=UINPBA00004M" "url" => 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"paginaFinal" => "e145" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Periartritis calcificante aguda de la articulación interfalángica proximal: una causa inusual de dolor agudo en el dedo de la mano" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1333 "Ancho" => 881 "Tamanyo" => 69080 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Anteroposterior radiograph at 2 months follow-up demonstrating resolution of the calcified lesion (arrow).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisca Aguiar, Iva Brito" "autores" => array:2 [ 0 => array:2 [ "nombre" => 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class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María Dolores" "apellidos" => "Abellán Rivero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Angela" "apellidos" => "Cepero Calvache" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Nuria" "apellidos" => "Lozano Rivas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Radiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Reumatología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gota que simula tumoración de partes blandas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1558 "Ancho" => 2167 "Tamanyo" => 183946 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CT image (A) and MR (B). The tumor is of lobulated morphology, a diffuse component with calcified areas inside which eroded the bony surfaces of the metacarpophalangeal joint (white arrow heads).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An 80 year-old male patient with a history of controlled high blood pressure, presented with a lesion in the dorsal region at the base of his third finger of the right hand, of several months duration. Physical examination of the lesion revealed that it was of solid consistency and partially deep layer attached. It was therefore diagnosed as a soft tissue tumor. An ultrasound scan was requested which detected a soft tissue mass with diffuse echotexture (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). In view of these findings, CT and MR scans were performed. From these tests we observed that the tumor had a lobulated morphology, contained calcifications and eroded the adjacent bony surfaces (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1B and 2</a>). The tumor enhanced heterogeneously following the administration of intravenous line contrast dye. As a result of these findings, we decided to perform a biopsy in which uric acid crystals were detected, confirming the diagnosis of arthropathy by crystal deposits (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Gout is the most common inflammatory arthropathy in men and is caused by monosodium urate deposits in joints and soft tissues.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,2</span></a> Although the first metatarsophalangeal joint is the most commonly affected, crystals may be distributed in any joint surface.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> This pathology has been classically called “the great mimicker” because of the many clinical presentations it may be adopt, with diagnosis thus becoming a challenge for the medical team.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> As a result, it is not surprising that there are reports of gouty tophi which mimic soft tissue tumors in regions like the hand, the forearm and the foot.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> Radiologic tests are often insufficient to differentiate this pathology from a tumor, and ultrasound-guided tissue biopsy should therefore be used to obtain an accurate diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3,4</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of people and animals</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that for this research no experimentation has been carried out on human beings or animals.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data confidentiality</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to their centre of work on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data have appeared in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of Interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-06-19" "fechaAceptado" => "2017-07-23" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Páez Granda D, Abellán Rivero MD, Cepero Calvache A, Lozano Rivas N. Gota que simula tumoración de partes blandas. Reumatol Clin. 2019;15:e146–e148.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 950 "Ancho" => 2167 "Tamanyo" => 116218 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) A soft tissue tumor is observed in the dorsal region at the base of the third finger, which is of diffuse echotexture (white arrow heads). (B) Image of CT locator: a lesion is observed which destroys the cortical of the head of the third metacarpal (white arrow head).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1558 "Ancho" => 2167 "Tamanyo" => 183946 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CT image (A) and MR (B). The tumor is of lobulated morphology, a diffuse component with calcified areas inside which eroded the bony surfaces of the metacarpophalangeal joint (white arrow heads).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1170 "Ancho" => 2167 "Tamanyo" => 128597 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Reconstruction in volume rendering is observed which reveals a tumor of soft tissue in the metacarpophalangeal joint. (B) The study with an optic microscope detected needle-shaped monosodium urate crystals inside the tumor.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging in gout: a review of the recent developments" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Chowalloor" 1 => "T. Siew" 2 => "H. Keen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1759720X14542960" "Revista" => array:6 [ "tituloSerie" => "Ther Adv Musculoskelet Dis" "fecha" => "2014" "volumen" => "6" "paginaInicial" => "131" "paginaFinal" => "143" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25342993" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gout" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Richette" 1 => "T. Bardin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(09)60883-7" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2010" "volumen" => "375" "paginaInicial" => "318" "paginaFinal" => "328" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19692116" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Can gout mimic a soft tissue tumour?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.W. Hee" 1 => "V.A. Singh" 2 => "P. Jayalakshmi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "BMJ Case Rep" "fecha" => "2010" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic dilemmas in unusual presentations of gout" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.H. Chui" 1 => "J.Y. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aust Fam Physician" "fecha" => "2007" "volumen" => "36" "paginaInicial" => "931" "paginaFinal" => "934" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18043781" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001500000006/v1_201911250632/S2173574318301618/v1_201911250632/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001500000006/v1_201911250632/S2173574318301618/v1_201911250632/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301618?idApp=UINPBA00004M" ]
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| 2021 December | 57 | 53 | 110 |
| 2021 November | 52 | 46 | 98 |
| 2021 October | 62 | 53 | 115 |
| 2021 September | 34 | 59 | 93 |
| 2021 August | 39 | 40 | 79 |
| 2021 July | 29 | 27 | 56 |
| 2021 June | 36 | 33 | 69 |
| 2021 May | 104 | 49 | 153 |
| 2021 April | 212 | 105 | 317 |
| 2021 March | 289 | 39 | 328 |
| 2021 February | 70 | 23 | 93 |
| 2021 January | 66 | 30 | 96 |
| 2020 December | 53 | 22 | 75 |
| 2020 November | 53 | 12 | 65 |
| 2020 October | 32 | 24 | 56 |
| 2020 September | 47 | 18 | 65 |
| 2020 August | 25 | 20 | 45 |
| 2020 July | 22 | 13 | 35 |
| 2020 June | 37 | 9 | 46 |
| 2020 May | 32 | 27 | 59 |
| 2020 March | 1 | 0 | 1 |
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