title: Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: First Department of Surgery, 417 NIMTS Veterans Administration Hospital of Athens, Monis Petraki 10-12, Athens, 11521,Greece. falidase@otenet.gr.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Falidas
authors.forename: Efstathios
authors.initials: E
authors.lastname: Rallis
authors.forename: Vasiliki-Kalliopi
authors.initials: VK
authors.lastname: Bournia
authors.forename: Stavros
authors.initials: S
authors.lastname: Mathioulakis
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Pavlakis
authors.forename: Constantinos
authors.initials: C
authors.lastname: Villias