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However, ultrasound imaging revealed multiple small hyperechoic areas with posterior acoustic shadowing with intermixed hypoechoic fluid within the proximal patellar tendon, consistent with gouty tophi. The patient underwent ultrasound\u2010guided needle barbotage of the tophi. Gout was confirmed by the presence of uric acid crystals in the aspirate. He had immediate pain relief. Ultrasound imaging 6 weeks later demonstrated healing of the tendon without tophi recurrence. At 6\u2010month follow\u2010up, the patient remained asymptomatic. This case highlights a rare cause of knee pain, promotes diagnostic ultrasound, and describes a novel treatment technique for intratendinous tophaceous gout.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>V<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2016.12.013","type":"journal-article","created":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T20:48:24Z","timestamp":1484599704000},"page":"938-942","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnosis and Treatment of Gouty Tophi in the Patellar Tendon Using Ultrasound\u2010Guided Needle Barbotage: A Case Presentation"],"prefix":"10.1002","volume":"9","author":[{"given":"Ricardo E.","family":"Colberg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel G.","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,1,16]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-013-1771-8"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.55.12.921"},{"key":"e_1_2_5_4_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3928\/01477447-20110124-33","article-title":"Intratendinous tophaceous gout imitating patellar tendonitis in an athletic man","volume":"34","author":"Gililland J.M.","year":"2011","journal-title":"Orthopedics"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.21910"},{"key":"e_1_2_5_6_2","first-page":"1164","article-title":"An update on gout: Diagnostic approach, treatment and comorbidity","volume":"141","author":"Diller M.","year":"2016","journal-title":"Dtsch Med Wochenschr"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.01.005"},{"key":"e_1_2_5_8_2","first-page":"354","volume-title":"Radiation Dose for Multidetector CT","author":"Reiser M.F.","year":"2012"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22009"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150366"},{"key":"e_1_2_5_11_2","unstructured":"Gruber M Bodner G Rath E et al. Dual\u2010energy computed tomography compared with ultrasound in the diagnosis of gout. Rheumatology (Oxford) 2013. Available at:http:\/\/reference.medscape.com\/medline\/abstract\/24136065. 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