Chronic Intra-tendinous Tophaceous Gout in Repaired Flexor Digitorum Superficialis Tendons of the Right Index and Middle Finger: A Case Report

Monosodium urate (MSU) crystal deposition in tendons is well documented in patients with gout.However, only a handful of cases have reported tophaceous gout infiltration into surgically repaired tendons, with only one reported in the flexor digitorum tendons.This case reports a 38-year-old male with a long-standing history of gout presenting with gouty tophi deposition in proximity to nonabsorbable sutures used for previously repaired flexor digitorum superficialis (FDS) tendons of the index finger (IF) and middle finger (MF).During debulking, the MF FDS tendon ruptured.Due to the loss of tendon structure, the FDS of the IF and MF were excised and reconstructed by pairing with their respective FDP tendons.To our knowledge, this is the first reported case of gouty tophi infiltration of repaired FDS tendons.In conclusion, this case emphasises the importance of anticipating rupture when debulking around repaired tendons and planning for reconstruction in advance.Furthermore, the factors contributing to MSU deposition in repaired tendons remain speculative and warrant further investigation to determine their aetiology.