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array:23 [ "pii" => "S2387020622002066" "issn" => "23870206" "doi" => "10.1016/j.medcle.2021.12.005" "estado" => "S300" "fechaPublicacion" => "2022-05-27" "aid" => "5891" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2022;158:502" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0025775321007429" "issn" => "00257753" "doi" => "10.1016/j.medcli.2021.12.011" "estado" => "S300" "fechaPublicacion" => "2022-05-27" "aid" => "5891" "copyright" => "Elsevier España, S.L.U." 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"documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2022;158:501" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Atrial myxoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "501" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mixoma auricular" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 265 "Ancho" => 1405 "Tamanyo" => 56344 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Isabel Ferreira, Sofia Torres, José Máximo, João Vilaça, Gonçalo Pestana, Filipe Macedo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ana Isabel" "apellidos" => "Ferreira" ] 1 => array:2 [ "nombre" => "Sofia" "apellidos" => "Torres" ] 2 => array:2 [ "nombre" => "José" "apellidos" => "Máximo" ] 3 => array:2 [ "nombre" => "João" "apellidos" => "Vilaça" ] 4 => array:2 [ "nombre" => "Gonçalo" "apellidos" => "Pestana" ] 5 => array:2 [ "nombre" => "Filipe" "apellidos" => "Macedo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0025775321007417" "doi" => "10.1016/j.medcli.2021.12.010" "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/S0025775321007417?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002054?idApp=UINPBA00004N" "url" => "/23870206/0000015800000010/v1_202206100851/S2387020622002054/v1_202206100851/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Tophaceous gout with bone destruction" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "502" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Sadettin Uslu" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Sadettin" "apellidos" => "Uslu" "email" => array:1 [ 0 => "sadouslu@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Rheumatology, Ömer Halisdemir University Bor Physical Medicine and Rehabilitation, Training and Research Hospital, Niğde, Turkey" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gota tofácea con destrucción ósea" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 917 "Ancho" => 1410 "Tamanyo" => 176985 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 60-year-old man with a long-standing history of gout who came to the rheumatology department due to a 6-month history of a painful swollen right foot and knee. He reported using no medication for about 2 years.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination, tenderness, swelling, and nodule with deposits of solid, yellow-white chalky material were observed on the lateral right midfoot (arrow) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Computed tomography (CT) showed severe erosive changes (arrowhead) and extensive tophaceous deposits (asterisk) of the foot and knee (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B–D). The blood test highlighted the elevation of uric acid and acute phase reactants. Aspirated synovial fluid from the right knee joint contained monosodium urate crystals. Gram staining and culture were negative.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The diagnosis of chronic destructive tophaceous gout was established, and treatment with allopurinol and colchicine was initiated. Furthermore, surgical excision and debridement of the tophi was performed. He was advised to avoid purine-rich foods and alcohol. Six months following initial presentation, clinical and laboratory improvement was observed.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The development of intraarticular tophi is characterized by chronic destructive articular involvement and is extremely difficult to treat. The appearance of intraarticular tophi on CT is quite specific. Early diagnosis and treatment of gout is key to preventing complications.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Peer-review</span><p id="par0030" class="elsevierStylePara elsevierViewall">Externally peer-reviewed.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Informed consent</span><p id="par0040" class="elsevierStylePara elsevierViewall">Informed consent was obtained from all individual participants included in the study.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">The author declared that this study has received no funding.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflict of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Peer-review" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Informed consent" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Funding" ] 3 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 917 "Ancho" => 1410 "Tamanyo" => 176985 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015800000010/v1_202206100851/S2387020622002066/v1_202206100851/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015800000010/v1_202206100851/S2387020622002066/v1_202206100851/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622002066?idApp=UINPBA00004N" ]
