What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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Findings The left knee radiographs demonstrate prominent soft tissue swelling anterior to the patella with subtle density/calcification. The MRI demonstrates a heterogeneous, intermediate to high signal intensity mass associated with the quadriceps tendon/prepatellar bursa. Within the knee itself is an intermediate signal intensity mass insinuated about the course of the popliteus tendon/popliteal groove. There is underlying advanced degenerative change of the patellofemoral compartment which is otherwise not germane to this case.
What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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What’s the Diagnosis – Case 132
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Diagnosis: Gout Gout is often a difficult diagnosis as it can present in so many ways. Of course related to a disturbance in uric acid metabolism, uric acid deposition induces an inflammatory/tophaceous response which can be juxta/periarticular or within a joint. Often on MRI gout will present with intermediate to lower signal on all pulse sequences but may also have higher signal on more T2 weighted or inversion recovery pulse sequences. On radiographs, soft tissue masses can be found and when subtle calcifications are present within the masses gout should be entertained as a diagnosis. The calcification is thought to be dystrophic or perhaps related to a degree of concomitant calcium pyrophosphate. Around the knee gout loves to involve the extensor mechanism and also the anterior synovialy lined bursae as seen in this case. In addition, it also anecdotally has a proclivity for the popliteal groove so much that any mass in that location should bring gout to mind. Any one finding in this case would be difficult to render a diagnosis but when placed in concert, the correct diagnosis can be deduced.
What’s the Diagnosis – Case 132
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