Tophaceous gout of the rotator cuff. A case report.

Soft-tissue tophaceous deposits have been reported in the finger, carpal tunnel, spine (cervical and lumbar), hip, knee, and Achilles tendon.1,3,6,8,10,13,16 Intraosseous and intradermal sites have also been described, and there is also a report of a tophus being the cause of fracture nonunion.4,5,17 Glenohumeral joint involvement in gouty arthropathy, however, is unusual.7 Tophaceous gout correlates with a longer duration of disease and a poor tolerance to medication. The clinical effects of intra-articular tophi are mostly caused by mechanical impingement.12 In the longer term, there is an increased rate of degenerative arthritis, although this association has been challenged.8,11 We have been unable to find any previous reports of tophaceous gout occurring within the glenohumeral joint or rotator cuff. We present such a patient and discuss imaging, treatment, and further management.