Gout of the temporomandibular joint and review of the literature.

Abstract

Gout is a disease characterised by abnormal deposition of monosodium urate crystals, typically affecting the extremities. This report describes a rare case of gout affecting the left temporomandibular joint with erosion of the skull base. A diagnosis of gout was suspected based on CT and MRI and confirmed with CT-guided biopsy. The temporomandibular joint is an uncommon location for a first presentation of gout, with very few cases documented and only three cases of skull base involvement reported in the English literature previously. Given its radiological appearance, it can easily be misdiagnosed as other erosive arthropathies or malignancy. Our paper highlights an unusual location for the first and only manifestation of gout and offers some diagnostic and treatment ideas that may help clinicians to identify and manage this disease.