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Gouty arthritis

Case contributed by Fatma Ahmed
Diagnosis almost certain

Presentation

Big toe pain and swelling

Patient Data

Age: 45 years
Gender: Male
mri

A marker was applied over the site of the patient's complaint.

  • erosive arthropathic changes of the 1st (underneath the applied marker) and, to a lesser extent, the 2nd metatarsophalangeal articulations evidenced by juxta-articular bony erosions with punched-out/overhanging edges, underlying mild marrow edema and pseudocystic changes, most evident at the big toe metatarsal head.
  • associated surrounding mass-like soft tissue sheets seen causing overlying contour bulge, likely representing tophi
  • mild metatarsophalangeal and interphalangeal joints effusion

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