Case contributed by Dr Praveen Jha


Pain in great toe for last year. No prior investigations were done.

Patient Data

Age: 44
Gender: Male

Characteristic T1 hypointense periarticular soft tissue rim is seen at 1st metatarsophalangeal joint, suggesting tophus.

Case Discussion

On further investigation, patient was found to have hyperuricemia, and diagnosis was confirmed as gouty arthritis.

As evident in the scans, there is no bony erosion. Patient came to me with a plain X-ray (not included here) a month back, which was normal. As the soft tissue swelling is hardly noticeable, and bony erosions are absent, plain radiograph may be misleading.

Typical presentation of pain in great toe should be evaluated by the MRI, which can detect gout in early stages, as seen in this case.

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Case information

rID: 17525
Published: 22nd Apr 2012
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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