Presentation
Forefoot pain and swelling.
Patient Data
Erosions at the first metatarsophalangeal joint with associated soft tissue swelling and density. Fusion of the 2nd toe proximal interphalangeal joint.
Extensive subcutaneous edema of the forefoot, particularly dorsally and medially.
Marginal erosions at the first metatarsal head with extensive peri-articular soft tissue swelling which is generally low T1, iso to high PD/T2 with foci of low T1 and PD/T2 signal. Bone marrow edema within the first metatarsal shaft. Mild edema within the hallux sesamoids. First metatarsophalangeal joint synovial thickening.
Susceptibility artefact within the second toe in keeping with the prior fusion.
Case Discussion
Typical findings of tophaceous gout on x-ray and MRI. On MRI, there can be extensive associated edema but referring to x-rays helps reassure that this is just gout.
Unable to process the form. Check for errors and try again.