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

Left Foot Tophi Photograph
Click photo for details
Voluminous, erupted and ulcerated nodule on the big toe joint of the left foot containing chalky material (on admission).

Feet Tophi Pictures: Xray

Left Foot Tophi Xray Photograph
Radiographs of the gouty foot.
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

Left Foot Tophi Resolved PhotographComplete healing of the ulcer 40 days after the initial observation.

Feet Tophi Case Report: Next Steps

Pretty nasty eh? Can you show worse? You can upload images in the gout forum. You can also discuss this gout research, or any other Gout Study Information.

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