This summary of an old forum discussion from July 2009 started about wine, but when the Original Poster added a picture of his foot, most of the interest was about gout in his second toe and baby (pinky) toe.
The story began with:
I had my first attack ever, second toe, gone in one day. I have been on restrictive diet for a week, lots of water, cherry juice, cherries etc. When is it safe to have 1 glass of wine (or do i wait a month or so?)
zip2play noted that second toe gout was uncommon, which prompted the following response:
Gout is not uncommon in your 2nd toe as this picture shows. It also shows my weeping tophi in my small toe.
Stick with your medication it will come good as long as you don’t have any adverse reactions. I am waiting for benzbromarone. Will post some pictures of my hands and elbows when i can get someone to take them!
More Tophus Chat
That little toe looks a mess. Is it very painful? My experience is that old tophi are annoying and sometimes slightly achey but never acutely painful.
The best thing for it is continued weeping?I wonder if there’s something you could do to enhance it
Let me narrate one of mine. I had a fairly painless tophus perhaps the size of white bean (larger than a pea, smaller than a kidney bean) on my end thumb joint on the side facing inward towards my body. It just laid there for perhaps 5 years. There really was no acute phase for it?it just appeared I’m not even aware of how fast. Since I played the clarinet for a long time I thought maybe it was arthritis from supporting the weight of the instrument?it’s the right thumb that carries all the weight.
So it just sat there for years and I could wiggle it around slightly under the skin. THEN it slowly started to move towards the end of my finger?maybe a millimeter a month. It encountered my thumbnail which slowed it down?but inexorably it started moving UNDER the nail (or moving with it as the nail grew. The nail bulged appreciably?several millimeters high. When it reached the middle of the nail I had had enough so I straightened a paper clip, held it with pliers and made it red hot. I plunged it through the nail which melted very easily almost like wax (surprised me.)
A seepage of opaque fluid began through the hole but what was striking was that it was the slipperiest material I have ever encountered?and being a guy I am aware how slippery some things can get. 😉 Being chemically trained I threw it under a microscope and saw what seemed to be dendritic crystals under polarized light. I should have dyed it properly but I wasn’t equipped to do it. I let some DRY and examined further?it turned to a MASS of sharp dendritic crystals.
Over a period of a month it all came out and I didn’t even lose the nail?it just continued to grow until the hole moved to clipper range. The tophus is completely gone.
What I conjecture was that my body expelled the tophus and it’s surrounding synovial fluid?which I conjecture is that super slippery stuff I mentioned.
It was one of the more amazing episodes in my life.