Gout - hands

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

Presents with right-hand pain and swelling with limited mobility.

Patient Data

Age: 60 years
Gender: Male

Right hand

x-ray

Features consistent with polyarticular gouty arthritis involving the 2nd and 3rd metacarpal-phalangeal articulations, 2nd to 5th PIP articulations, and the 3rd-5th DIP articulations. There are classical juxta-articular punched-out erosions and overhanging edges involving especially the 3rd DIP joint.

6 years prior

x-ray

On PACS review, the patient had mild gouty arthritis involving the right 2nd and 3rd PIP articulations, right 4th PIP joint (symptomatic joint ) and minimally right 2nd -5th DIP articulations

There is gouty arthritis of predominantly the left 2nd- 5th PIP articulations and additionally the left ulna styloid.

Case Discussion

Features consistent with gouty arthritis of the hands, of which this patient has a history of, with early erosions 6 years back and progressive changes on most recent X-rays.

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