Article Text
Erosive polyarticular tophaceous gout: an unusually deforming and destructive presentation
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Description
An 87-year-old man was referred to our rheumatology clinic for assessment of painful, swollen and deformed fingers. He had a history of longstanding, but suboptimally treated gout, which had resulted in previous amputation of his left middle finger. On examination, there was marked digital deformity. The right index finger was erythematous, with multiple tophaceous deposits (figure 1). There was a severe loss of digital flexion and extension. Radiographs of both hands demonstrated punched-out juxta-articular erosions involving the metacarpophalangeal joints bilaterally (figure 2). There was marked soft …