Intraosseous gouty tophus of the talus, treated by total curettage and calcium phosphate cement filling: a case report.

Long-term untreated hyperuricemia induces repeatable arthritis that results in chronic arthritis.(7) Under continuous hyperuricemia condition, monosodium urate crystal deposition occurs not only in joints but also in connective tissue or interosseous spaces.(4,9) Intraosseous gouty invasion, a relatively rare condition, has been reported to occur in the femoral condyle,(6) the clavicle,(12) the patella,(3) the vertebral body,(17) and the talus.(16) Gouty invasion in the talus is an especially rare condition. Only three reports describing a lesion in the talus were available. (5,13,16) The established operative procedure for large intraosseous gouty invasion is curettage and bone grafting.(6, 17) We present a patient in whom an intraosseous gouty tophus in the talus was treated by total curettage and filling the defect with calcium phosphate cement (CPC: alpha-tricalcium phosphate; Biopex-R, Mitsubishi Material, Osaka, Japan).