Rehabilitation Practice and Science
Translated Title
關節內注射天然成份玻尿酸後之痛風發作
Abstract
Viscosupplementation by intraarticular administration of exogenous hyaluronic acid has been a favorable treatment option to alleviate the symptoms of knee osteoarthritis. The potential but uncommon adverse reactions associated with intraarticular hyaluronic acid injection are local pain, swelling, and allergic response. These reactions are typically mild, transient, and self-limiting. The focus of this report is an 80-year-old man who presented with acute painful swelling of his knee joint after an injection of naturally derived hyaluronic acid. Aspiration of knee joint effusion yielded 40 mL of turbid straw-colored fluid. Synovial fluid cell counts revealed numerous leukocytes with a marked predominance of neutrophils. Intraleukocytic needle-shaped crystals with intensely negative birefringence were identified with polarized light microscopy, indicating monosodium urate crystals that are typically seen in acute gouty arthritis. The synovial fluid was sterile in culture. His knee pain reduced significantly after arthrocentesis and non-steroidal anti-inflammatory drug treatment. To the best of our knowledge, this is the first description of an attack of acute gout following intraarticular injection of naturally derived hyaluronic acid. The possible mechanisms were discussed with a reviewarticle of the relevant literature.
Language
English
DOI Link
https://doi.org/10.6315/2007.35(2)06
First Page
105
Last Page
110
Recommended Citation
Chen, Chih-Kuang; Lin, Chin-Yew; Chu, Ngok-Kiu; Lin, Cheng-Yi; and Tang, Simon Fuk-Tan
(2007)
"Attack of Gouty Arthritis after Intraarticular Injection of Naturally Derived Hyaluronic Acid,"
Rehabilitation Practice and Science: Vol. 35:
Iss.
2, Article 6.
DOI: https://doi.org/10.6315/2007.35(2)06
Available at:
https://rps.researchcommons.org/journal/vol35/iss2/6
