Swollen great toe. Known history of gout.
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Extensive periarticular lucency centred on the DIP joint of the great toe. Large amount of bony destruction with punched-out periarticular erosions.
Large punched out erosion on the medial aspect of the medial cuniform in the mid-foot.
Gout is commonest in the great toe.
The erosions are typically punched-out (aka rat bite erosions).