Gout

Case contributed by Dr Ian Bickle

Presentation

Swollen great toe. Known history of gout.

Patient Data

Age: 55
Gender: Male
X-ray

Extensive periarticular lucency centered 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.

Case Discussion

Gout is commonest in the great toe.

The erosions are typically punched-out (aka rat bite erosions).

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