title: [Tophaceous gout].
abstract: Identification of tophi indicates a definitive diagnosis of gout. However, recently they are rarely encountered. Tophi are most often seen in tissues that have a poor blood supply and low temperature, such as the ear helix and first MP joint. The nodules are yellowish-white, and non-tender, and range in size from 1 mm to 7 cm. Aspiration yields a chalky-like material that appears as needle-like crystals under light microscopy. In more advanced cases, tophi have a "punched-out" appearance with an "overhanging" margin on X-ray images. Differential diagnoses include rheumatoid nodules, xanthoma tuberosa, and CPPD crystal deposition diseases. Tophi respond well to anti-hyperuricemic therapy, during which they gradually decrease in size. However, a huge nodule may need to be surgically removed.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Moriwaki
mesh_terms: D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006073:Gout / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D033461:Hyperuricemia / Q000150:complications; D019637:Orthopedic Procedures
chemical_list: D006074:Gout Suppressants