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Tophaceous gout

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Painful feet swelling.

Patient Data

Age: 35 years
Gender: Male
x-ray

Juxta-articular punched-out erosions of the first and fifth metatarsal heads with overhanging edges are typical for gout. Overlying soft tissue swelling and increased density represent tophi.

Case Discussion

The features on x-rays are consistent with gout which is a crystal arthropathy due to the deposition of monosodium urate crystals in and around the joints.

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