Erosive Polyarticular Chronic Tophaceous Gout in a Young Man
A 27-year-old man was referred to us for joint pain and nodular swelling over multiple joints. His symptoms started when he was 13 years old, but he was sub-optimally treated.
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Explore This IssueMay 2022
On examination, we found marked digital deformity, with multiple large tophi over the small joints of his hands, elbows, knees and both feet.
Hand radiographs revealed large erosions and osteolysis over the second metacarpophalangeal joints of both hands, multiple soft tissue tophi and punched-out juxta-articular erosions of other small joints. A diagnosis of erosive polyarticular tophaceous gout was made.
The patient was treated with colchicine and allopurinol, and education was provided.
Wendy Wan Hui Lee, MD, MRCP(UK), is an internist and rheumatology fellow at Sarawak General Hospital, Kuching, Malaysia.
About the Contest
The Rheumatology Image Library is a highly accessed teaching resource. However, images showing manifestations of rheumatic disease on skin of color are under-represented, creating a significant educational gap. The 2021 Image Competition, held in conjunction with ACR Convergence 2021, encouraged the global rheumatology community to submit images that will help healthcare providers identify rheumatic disease manifestations in skin of color. Here, we depict the image featured from East Asia & Pacific. In coming issues, we’ll publish the winning images from other regions around the world. The images judged Best Overall and People’s Choice appeared in previous issues.