Gout: hand and foot changes

Case contributed by Dr Henry Knipe

Presentation

Long-standing hand and feet pain.

Patient Data

Age: 80
Gender: Male
X-ray

There are periarticular erosions at the first metatarsophalangeal and second proximal interphalangeal joints as well as at the lateral tarsometatarsal joint and talonavicular joints with sparing of the joint space and articular surfaces.     

X-ray

Marked soft tissue swelling demonstrated over the right index finger DIP joint with destruction of the underlying middle phalanx distally and proximal aspect of the distal phalanx. There is some faint soft tissue calcification. The bony margins are benign. PIP joint and remaining joints in the right index finger are normal. Degenerative changes are seen in the DIP and PIP joints of the remaining fingers. No other bony injuries/fracture

CONCLUSION: Appearances are consistent with progressive tophaceous gout causing bony destruction. 

Case Discussion

Findings are typical of gout and this patient has a known history of gout. 

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Case information

rID: 30748
Case created: 1st Sep 2014
Last edited: 31st Aug 2015
Inclusion in quiz mode: Included

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