First metatarsal head gout

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Pain and swelling.

Patient Data

Age: 70 years
Gender: Male
x-ray

Erosion of the medial margin of the first metatarsal head with overhanging edges. Marked soft tissue swelling overlying the erosion with increased density, in keeping with a tophus.

Smaller erosions of the medial and lateral base of the first proximal phalanx and the lateral margin of the first metatarsal head.

Case Discussion

Typical example of gout in a typical location.

The patient had hyperuricemia.

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