Gout is a common metabolic disease. Gouty arthritis is associated with the deposition of urate crystals in the synovial fluid or para-articular soft tissues, which often affects the hands, feet, wrists, ankle and knees joints. However, the shoulder joint is unusual involved. In the present study, a 49-year-old male patient complained of right shoulder pain for 9 months and aggravating with limited range of motion for 2 weeks. Physical examination showed that the external rotation was 10° and hand back was S 5 of the right shoulder. The MRI showed shoulder joint effusion and intra-articular loose bodies. The patient was admitted to the hospital with the diagnosis of "loose bodies of the right shoulder with synovial chondromatosis possibly". Arthroscopic examination revealed that a lots of urate crystals were deposited on synovium, cartilage and rotator cuff. Loose bodies removal and joint debridement were performed. Histopathologic examination of the specimen demonstrated synovitis hyperplasia with urate crystals deposition. Shoulder gouty arthritis characterized by pain and limited movement. The imaging of tophi depends on the calcium-containing deposits. Tophus with calcium deposits can be found on X-ray and CT. MRI can not only evaluate the tophus but also the evaluate the other intra-articular pathologies. Due to no typical manifestations and specific images of shoulder gouty arthritis, pathological diagnosis is the "gold standard". Shoulder arthroscopy provide a minimal invasive technique in diagnosing and treating of the shoulder disease. Undoubtedly, it could be a reliable diagnosis and treatment method for shoulder gouty arthritis.

BACKGROUND:The use of normal hyaline cartilage to repair large areas of full-thickness knee cartilage defect has been a hot topic recently; however, a follow-up study with a relative large number of patients is required. OBJECTIVE:To make a preliminary study concerning the methods and therapeutic effects of tissue-engineered cartilage (TEC) implantation for treating large-area full-thickness knee cartilage defects. METHODS:Twenty-one patients (23 knees) diagnosed with cartilage defect of the knee joint (Outbridge III-IV) were enrolled. The area of the cartilage defect was 3.5-11.2 cm2. All of the patients were given TEC treatment. Postoperative functional exercise of the knee joint was carried out in these patients as planned. We regularly reviewed the knee MRI and calculated visual analog scale score, International Knee Documentation Committee (IKDC) score, and Lysholm score. RESULTS AND CONCLUSION:All the patients were followed up for 3 to 12 months. Postoperatively knee pain relieved obviously, and the visual analog scale score was significantly declined compared with the preoperation (P<0.05). All the patients manifested painless 1 year after surgery. The 1-year postoperative MRI showed that the injured cartilage grew well. The thickness and MRI signal of the graft was the same as the normal cartilage, and the bone healed completely. The IKDC and Lysholm scores were significantly improved at 3, 6, 12 months after the surgery, and the difference was statistically significant before and after the surgery (P<0.05). Overall, TEC is an improved technique of chondrocyte implantation, which is an effective and safe method for cartilage defect repair.