Case contributed by Dr Matthew Lukies


Persistent wrist pain. Tenderness over the distal ulnar.

Patient Data

Age: 80 years
Gender: Male
  • Multiple well-circumscribed punched-out bony erosions with sclerotic margins, particularly in the ulnar styloid, triquetrum and distal first proximal phalanx
  • Juxta-articular soft tissue cloudy densities and swelling distal to the ulnar and radial to the second metacarpo-phalangeal (MCP) joint

CT findings confirm the features on x-ray, with multiple punched-out bony erosions and juxta-articular soft tissue cloudy densities and swelling.

Case Discussion

X-ray and CT findings in this case are characteristic of tophaceous gout.

The patient was treated with anti-inflammatory and urate-lowering medications, and demonstrated a good response.

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Case information

rID: 53874
Published: 11th Jun 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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