Gout arthropathy

Case contributed by Naim Qaqish
Diagnosis certain


Known to have gout arthritis presenting with first toe arthralgia.

Patient Data

Age: 90 years
Gender: Male

Well defined "punched out" erosive changes with sclerotic margins in a marginal and juxta-articular distribution and overhanging edges "rat bite erosions" of the head of the first metatarsal bone and around the interphalangeal joint of the big toe 

Periarticular hyperdense soft tissue swelling "tophi" is seen.

Diffuse degenerative and osteoprotic changes are also noted.

Findings are typical of gout arthritis.

Case Discussion

This is a case of a 90 year old gentleman who presented to the clinic with first toe arthralgia and redness. He was known to have gout and was also diabetic, but non-adherent with his medication and nutritionist recommendations. X-ray of his right foot was requested and shows typical findings of gout.

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