Unusual Gouty Tophi Simulating Malignancy

Abstract

Gout is a disorder of uric acid metabolism, characterized by deposition of monosodium urate crystals in joints and periarticular soft tissues as well as renal calculi and chronic nephropathy. The accumulation of crystals in the joints and periarticular soft tissues may cause recurrent episodes of inflammatory arthritis. Over the years, chronic form may occur with the presence of tophi and chronic arthropathy frequently in peripheral and rarely in axial joints. Surgical intervention is usually reserved for cases of recurrent attacks with deformities, severe pain and joint destruction.(1) In this article, we present a case of tophaceous gout with destructive bony changes simulating malignancy in X-ray which, to the best of our knowledge, has not been reported previously. In addition, we emphasize the importance of early debridement of tophi to avoid amputation.