These images are from a summary of a new case study about tophi in the left foot.
This ties in with a recent review of unusual tophi presentation (search for occupational gout)
The working title of my summary is How Bad Can Feet Tophi Get?
I think you’ll understand the title better once you see the images, but first the abstract.
Feet Tophi Case Report: Abstract
- Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report.
- Falidas E, Rallis E, Bournia VK, Mathioulakis S, Pavlakis E, Villias C.
- J Med Case Rep. 2011 Aug 19;5:397.
In my summary, I will use laymans terms to explain the medical terms and issues. Multiarticular means affecting many joints.
Feet Tophi Case Report: Introduction
Gout is a common inflammatory arthritis caused by articular precipitation of monosodium urate crystals. It usually affects the first metatarsophalangeal joint of the foot and less commonly other joints, such as wrists, elbows, knees and ankles.
The first metatarsophalangeal joint is the big toe, or bunion joint. I focus on feet here, but will include other joints in my published summary.
Feet Tophi Case Report: Case Presentation
We report the case of a 75-year-old Caucasian man with tophaceous multiarticular gout, soft-tissue involvement and ulcerated tophi on the first metatarsophalangeal joint of the left foot, on the first interphalangeal joint of the right foot and on the left thumb.
Feet Tophi Case Report: Conclusion
Ulcers due to tophaceous gout are currently uncommon considering the positive effect of pharmaceutical treatment in controlling hyperuricemia. Surgical treatment is seldom required for gout and is usually reserved for cases of recurrent attacks with deformities, severe pain, infection and joint destruction.
Feet Tophi Case Report: Pictures
Feet Tophi Pictures: On Admission
Voluminous, erupted and ulcerated nodule on the big toe joint of the left foot containing chalky material (on admission).
Feet Tophi Pictures: Xray
Total destruction of the big toe joint and soft tissue swelling is shown as is focal involvement of upper and lower surface of the foot (inflammation of the fatty layer of tissue under the skin).
Feet Tophi Pictures: Resolved
Feet Tophi Case Report: Next Steps
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