BMJ Case Reports 2011; doi:10.1136/bcr.07.2011.4548
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Painless nodules over joints with ulceration

  1. Rakesh Biswas
  1. Department of Medicine, People’s College of Medical Sciences, Bhopal, India
  1. Correspondence to Rakesh Biswas, rakesh7biswas{at}


A 30-year-old male presented with swellings over left elbow, left ankle, base of the first meta-tarso-phalangeal joint of both feet (figures 1–3). He had ulcers over swelling of right meta-tarso-phalangeal joint and dorsum of same foot since 3 months. He also had polyuria and low-grade fever since 6 months. There was a chalky white discharge from the ulcers, which on examination under polarised microscope showed large number of needle shaped crystals with negative …

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