To report a case of bilateral Achilles tendon rupture in a patient with advanced tophaceous gout following recent fluoroquinolone treatment, highlighting the potential complications associated with gout.
Approach:
Patient Case: A 68-year-old man with poorly controlled tophaceous gout presented with foot deformity and experienced an acute 'popping' sensation after taking levofloxacin.
Imaging and Diagnosis: MRI revealed extensive intratendinous tophaceous deposits and bilateral Achilles tendon ruptures.
Management: Serum urate levels were high, and allopurinol dosage was increased to optimize gout management before considering surgical intervention.
Key Findings:
Bilateral Achilles tendon ruptures were identified approximately 6 to 6.5 cm proximal to the calcaneal insertion.
Extensive intratendinous tophaceous deposition was observed in multiple tendons.
Fluoroquinolone exposure may increase the risk of tendon injury in patients with pre-existing conditions related to gout.
Interpretation:
This case illustrates a complication of gout involving chronic tendon involvement that can lead to structural failure.
Limitations:
The study is based on a single case report, limiting generalizability.
No control group or comparative analysis was conducted.
Conclusion:
The findings highlight the importance of recognizing tendon involvement in gout and the associated risks with fluoroquinolone treatment.
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