{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T10:31:41Z","timestamp":1774866701757,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,3,9]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>A 38-year-old man presented with a 2-month history of pain and stiffness in the bilateral wrist. The pain in right wrist was disabling and severe enough to restrict the daily life activities. After the evaluation of clinical and radiological features, the patient was diagnosed with Kienb\u00f6ck\u2019s disease Lichtman stage IIIB in the right wrist and stage IIIA in the left wrist. Routine laboratory investigations revealed a serum uric acid 9.27\u2009mg\/dL. Lunate excision and scaphocapitate fusion were done in the right wrist after discussing with the patient. The histopathological examinations of tophi in synovial tissue were negatively birefringent under polarised light microscopy. It confirmed the diagnoses of gout. Febuxostat was started postoperatively. The patient returned to work at the end of 5 months. There was no recurrence of symptoms and radiological signs of arthritis at the end of 1\u2009year.<\/jats:p>","DOI":"10.1136\/bcr-2019-233725","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T06:34:27Z","timestamp":1584945267000},"page":"e233725","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Bilateral Kienb\u00f6ck\u2019s disease concomitant with gouty arthritis"],"prefix":"10.1136","volume":"13","author":[{"given":"Deepak","family":"Chouhan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4609-6891","authenticated-orcid":false,"given":"Mohammed Tahir","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,3,22]]},"reference":[{"key":"2025082802083688000_13.3.e233725.1","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.2106\/00004623-199808000-00008","article-title":"Kienb\u00f6ck disease and negative ulnar variance","volume":"80","author":"Bonzar","year":"1998","journal-title":"J Bone Joint Surg Am"},{"key":"2025082802083688000_13.3.e233725.2","doi-asserted-by":"publisher","DOI":"10.3109\/03009749709065726"},{"key":"2025082802083688000_13.3.e233725.3","doi-asserted-by":"crossref","unstructured":"Lanzer W , Szabo R , Gelberman R . 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Gout, hyperuricemia, andaseptic necrosis of the femoral head, idiopathic ischemic necrosis of the FemoralHead in adults. WMZinn. Stuttgart, Georg Thieme Publishers, 1971: 134\u20138."},{"key":"2025082802083688000_13.3.e233725.12","doi-asserted-by":"publisher","DOI":"10.1080\/02844310310007827"},{"key":"2025082802083688000_13.3.e233725.13","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(84)90054-8"},{"key":"2025082802083688000_13.3.e233725.14","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/02844310050160097","article-title":"Scapholunate dissociation caused by gouty arthritis of the wrist. Case report","volume":"34","author":"Ohishi","year":"2000","journal-title":"Scand J Plast Reconstr Surg Hand Surg"},{"key":"2025082802083688000_13.3.e233725.15","unstructured":"Jaffe ML . Metabolic, degenerative, and inflammatory diseases of bones andJoints. 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