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Swelling of the great toe of left foot with
h/o of hyperuricemia
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X ray shows juxta-articular erosive changes around the first metatarsophalangeal(MTP) joint with overhanging edges and associated with a moderate soft tissue swelling.
However the joint space is maintained.
No evidence of osteopenia.
A: Psoriatic arthritis. However the erosions are at the distal inter-phalangeal joints commonly involving the hands.
Q: What does tophus indicate ?
A: A chronic state of disease.
This is a case of crystal deposition arthropathy known as Gout.
Gout occurs due to deposition of calcium urate crystals which are seen as well defined hyperdense area on plain radiograph known as a tophus.
1st MTP joint is the commonest joint to be involved.
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