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Infection of a tophaceous nodule of the wirst and hand
  1. Wajdi Bouaziz,
  2. Mohamed Ali Rekik,
  3. Ahmed Racem Guidara,
  4. Hassib Keskes
  1. Orthopaedic, CHU Habib Bourguiba, Sfax, Tunisia
  1. Correspondence to Dr Wajdi Bouaziz, bouaziz.w{at}


Tophaceous gout occurs years after recurrent attacks of acute inflammatory arthritis. The urate deposits are incriminated in the inflammatory process; however, their infection is exceptional. We report the observation of an infected gouty tophus of the pinky and the wrist of a 40-year-old man, presented as an excruciating inflammatory pain with buff-yellow swelling of the fifth right finger and wrist in a febrile context. As a matter of fact, the evolution was favourable after surgical excision and antibiotic therapy. The infection of a tophus is an exceptional complication of the gout. In daily practice, this diagnosis is really a difficult challenge for the clinician. The systematic bacteriological examination of the tophi with cutaneous fistulation is necessary to introduce prematurely an adapted treatment.

  • bone and joint infections
  • orthopaedics
  • biological agents

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  • Contributors All authors contributed to the drafting of this article. MAR and ARG contributed to the conception and design. WB and HK contributed to the analysis and interpretation of data.

  • Funding The authors declared they haven’a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.