title: Tophi - surgical treatment.
abstract: Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.
authors.affiliation: Department of Neuroorthopaedics and Neurology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Słowińska
authors.affiliation: Department of Neuroorthopaedics and Neurology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
authors.forename: Radosław
authors.initials: R
authors.lastname: Słowiński
authors.affiliation: Pediatric Rheumatology Clinic, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
authors.forename: Lidia
authors.initials: L
authors.lastname: Rutkowska-Sak
keywords: diagnostic difficulties; surgery; tophi