Tophaceous gout

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Painful focal foot swelling, bilaterally.

Patient Data

Age: 55 years
Gender: Male
x-ray

There are several well-circumscribed punched-out bony erosions with sclerotic margins, especially at first MTP joints, bilaterally. Juxta-articular soft tissue densities and swelling are also visible.

Case Discussion

Findings of x rays are characteristic of tophaceous gout.

The typical appearance of gout on x ray evaluation is the presence of well-defined “punched-out” erosions with sclerotic margins in a marginal and juxta-articular distribution, with overhanging edges. Tophi are pathognomonic feature of gout.

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