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Case contributed by Dr Ian Bickle


History of gout. Swollen deformed great toe.

Patient Data

Age: 70
Gender: Male

Lucency and bony erosion and destruction of the distal and proximal phalanges of the great toe centered on the DIP joint.  Associated soft tissue swelling.

No calcification in the soft tissues.

Erosion on the dorsal aspect of the medial cuniform.


The Gout (James Gillray, 1799) depicts the pain of the artist's podagra as a demon or dragon

James Gillray 1756-1815) was a British caricaturist and printmaker famous for his distinct style of political and social satire cartoons and hence his iconic status as the father of the political cartoon.

The original image can be found:  (This image is free of copyright and can be used without any license requirements.

Case Discussion

This is an extreme example of very advanced gout.  The big toe is a classic site and historically well documented with the term podagra.



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Case information

rID: 50388
Published: 10th Jan 2017
Last edited: 14th Aug 2019
Tag: rdgh
Inclusion in quiz mode: Included

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