“Surgical management of unusual large tophi in chronic tophaceous gout: A case report”

Abstract

Gout is a disorder of purine metabolism a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot, and swollen joint. Pain typically comes on rapidly, reaching maximal intensity in less than twelve hours. The first metatarsophalangeal joint is affected in about half of cases. It may also result in tophi, renal stones, or urate nephropathy. Commonly, but very large tophi are unusual in chronic gout. Here we present 52 years male patient presenting with unusually large tophi over bilateral foot, with raised serum uric acid levels. In a untreated cases of chronic gout, patients can develop severe destructive poly articular involvement and tophi. Treatment aims at control of serum uric acid levels which can cause regression of tophi. And surgical excision of very large tophi.