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Images in rheumatology
Clinical image: tophus in the sternoclavicular joint
  1. Si Chen1,
  2. Fengjing Liu1,2,
  3. Jie Chen3,
  4. Geng Gu4,
  5. Haoyong Yu1
  1. 1 Department of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai, China
  2. 2 Department of Endocrinology and Metabolism, Haikou Orthopedic and Diabetes Hospital, Haikou, Hainan, China
  3. 3 Department of Ultrasound in Medicine, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People’s Hospital, Shanghai, China
  4. 4 Department of Radiology, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China
  1. Correspondence to Dr Haoyong Yu; yuhaoyong{at}shsmu.edu.cn

https://doi.org/10.1136/ard-2024-225609

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    A 51-year-old man presented with persistent pain localised to the right clavicle after consuming 1600 mL of beer. The patient has a medical history of gout but no history of trauma or infection at the lesion site. Physical examination showed that the patient’s temperature was of 37.4°C, presenting only pain in the right sternoclavicular joint and no symptoms of pain in any other joint. Laboratory examination showed normal serum uric acid levels (412 µmol/L; normal range: <420 µmol/L) and elevated erythrocyte sedimentation rate (ESR) (19 mm/hour; normal range: <15 mm/hour). One year prior, the patient underwent surgical intervention to remove tophus from both elbow and ankle joints. After the operation, the patient adhered to a regimen of febuxostat regularly.

    Long-axis grey-scale ultrasound showed a …

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    Footnotes

    • SC and FL are joint first authors.

    • Handling editor Josef S Smolen

    • SC and FL contributed equally.

    • Contributors SC and FL prepared the clinical image and the medical description of the case. All the authors were in charge of the patient during his hospitalisation and provided information on the patient’s evolution. SC, FL, JC, GG and HY discussed the manuscript and contributed to the final version.

    • Funding This study was supported by grants from National Natural Science Foundation of China (82300946), Hainan Provincial Natural Science Foundation of China (822MS207), the Clinical Research Plan of SHDC (SHDC2020CR1017B), Shanghai Municipal Key Clinical Specialty and Shanghai Science and Technology Commission (21Y11910900).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.