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首页> 外文期刊>Medicine. >Atypical musculoskeletal manifestations on flexor hallucis longus tendon of gout causing tarsal tunnel syndrome in diabetic patients: A case report
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Atypical musculoskeletal manifestations on flexor hallucis longus tendon of gout causing tarsal tunnel syndrome in diabetic patients: A case report

机译：肌肉肌腱肌腱肌腱肌腱肌腱肌腱肌腱肿瘤肌腱肿瘤患者的非典型肌肉表现出：案例报告

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Rationale: Deposition of tophus is a common feature in chronic gout ; however, signs and symptoms are not always well-pronounced in cases of uncommon sites. We report a rare case with a tophaceous tendonitis on the flexor hallucis longus (FHL) tendon with tarsal tunnel syndrome (TTS). This is the first surgical case of TTS by gouty tophi in FHL. Patient Concerns: A 55-year-old woman presented with a 6-month history of mild discomfort at the right foot, which gradually worsened in the past 3 weeks. The patient visited our outpatient clinic due to persistent and aggravating foot pain and swelling around the tarsal tunnel. Diagnosis: The patient was diagnosed with hyperuricemia and diabetes mellitus with chronic kidney disease, and did not receive regular antigout treatments. Paresthesia was found along the distribution of medial and plantar nerve and tinel test was positive on tarsal tunnel. Biochemical examination showed she had raised serum uric acid (10.6 mg/dL) and decreased estimated glomerular filtration rate (69 mL/min/1.73 m 2 ). Conventional radiography examination showed negative pathology except soft tissue swelling. Magnetic resonance imaging revealed a fusiform mass within the FHL tendon and fluid collection around tarsal tunnel. Interventions: Surgical exploration was performed to remove the mass. Inflammation fluid exploded out from FHL tendon sheath, which was later proven to have infiltration of monosodium urate crystal. Superficial dissection revealed a white chalky mass and posterior tibial nerve was significantly compressed by the tophus mass. Outcomes: The mass was removed and the symptoms were relieved at immediate postoperative period. Lessons: A tophaceous tendonitis on FHL tendon can cause TTS and surgical decompression of the gout lesion can reduce the symptoms.
机译：理由：Tophus的沉积是慢性痛风中的一个共同特征;然而，在罕见地点的情况下，迹象和症状并不总是发明。我们在屈曲uhatucis kongus（FHL）肌腱上报告了罕见的患者，具有Ttsal隧道综合征（TTS）。这是FHL中痛风TOPHI的第一个TTS的第一个手术案例。患者担忧：一名55岁的女性，右脚患有6个月的轻微不适的历史，在过去的3周内逐渐恶化。患者因持续和加重脚疼痛而围绕着塔形隧道肿胀而访问了我们的门诊诊所。诊断：患者被诊断患有高尿酸血症和糖尿病，慢性肾脏疾病，并未接受常规抗原治疗。沿着内侧和跖骨神经分布发现的感觉术和Tinel试验在t骨隧道上阳性。生物化学检查显示她已经升高了血清尿酸（10.6mg / dL）并降低了估计的肾小球过滤速率（69ml / min / 1.73m 2）。传统的射线照相检查显示除软组织肿胀之外的阴性病理学。磁共振成像显示出FHL肌腱和流体收集内的梭形质量，缠绕塔尔隧道周围。干预：进行手术勘探以消除质量。从FHL肌腱护套中爆炸的炎症液，后来被证明是对尿液晶体渗透的渗透。浅表剖析显示出白垩质量和后胫骨神经被托巴斯质量显着压缩。结果：除去肿块，症状在术后期间释放。课程：FHL肌腱上的Tophaceous肌腱炎可能导致TTS和手术减压痛风病变可以减少症状。

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