Tophaceous gout

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Bilateral painful focal foot swelling

Patient Data

Age: 55 years
Gender: Male
x-ray
Frontal
Oblique
Frontal
Oblique
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Several well-circumscribed punched-out bony erosions with sclerotic margins exist bilaterally, particularly in the vicinity of the first MTP joints.

Juxta-articular soft tissue densities and swelling are also visible.

Case Discussion

Findings of x-rays are characteristic of tophaceous gout.

The typical appearance of gout on x-ray evaluation is the presence of well-defined, punched-out erosions with sclerotic margins in a marginal and juxta-articular distribution with overhanging edges. Tophi are also pathognomonic features of gout.

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