Subtle toe gout erosion
Pain in second toe
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There is a rounded juxta-articular erosion of the medial head of the second toe middle phalanx overhanging edges, suggestive of gout. No other erosion is identified. Associated soft tissue swelling is noted. No soft tissue calcification. Incidental plantar and posterior calcaneal spurs.
This was the patient's first presentation with gout, confirmed with elevated uric acid levels.