In addition, there have been reports of unusual sites or presentations of tophaceous disease. [cureus.com]

Our case presented as a white subcutaneous mass resembling an epidermal inclusion cyst. [hindawi.com]

Examine these images and note the features that are present and also the features that would have been present if the tissue had been processed differently. 2. Discuss the etiology and pathogenesis of gout. 3. [medicine.tamu.edu]

Case Discussion Ultrasound can demonstrate urate deposition, tophus, and vascularization that are present throughout the Achilles tendon in patients with tophaceous gout 1. [radiopaedia.org]

The number of cells present in the corona and fibrovascular zones of the tophus was analyzed by Genmod mixed models analysis. RESULTS: Numerous CD68+ mononucleated and multinucleated cells were present within the corona zone. [ncbi.nlm.nih.gov]

• Relapsing Polychondritis

  Polychondritis (2) Sebaceous Cyst (6) Solid-Cystic Basal Cell Carcinoma (85) Synovioma (3) Xanthoma Tuberosum (1) related links Search www.google.com for 'Gouty Tophus' Informationen über Rheuma [dermis.net]

• Joint Deformity

  Overview Chronic symptoms such as joint deformity and limitation of motion in affected joints may occur if several attacks of gout occur each year. Uric acid deposits called tophi develop in cartilage tissue, tendons, and soft tissues. [medlineplus.gov]

  Complications include bone destruction, joint deformities, and, as in the present case, secondary infections. Diagnosis can be made on clinical grounds and confirmed with the visualization of uric acid crystals under light microscopy. [jaoa.org]

  The formation of these mineralized masses can also lead to chronic arthritis and joint deformity. Causes Tophi generally start to develop in the joints and tissues in the advanced chronic tophaceous stage. [verywellhealth.com]

• Tendon Disorder

  (disorder) | 447562003~MAPRULE~IFA 402470003 | Gouty tophus of digit (disorder) | 447562003~MAPTARGET~M10.08 6011000124106~MAPPRIORITY~2 447562003~MAPPRIORITY~4 447562003~MAPRULE~IFA 281365008 | Gouty tophus of prepatellar bursa (disorder) | 447562003 [bioportal.bioontology.org]

• Subcutaneous Nodule

  The left lateral maleollus had a fistulized nodule draining a wet chalk-like material. Due to the articular findings and the presence of subcutaneous nodules, the diagnostic hypotheses included tophaceous gout and rheumatoid arthritis. [scielo.br]

  In 1996, Iglesias et al. reported a case presented with a 6-year history of multiple subcutaneous nodules and no history of previous articular complaint. [16] They had reviewed literature and found out 28 similar cases that had subcutaneous nodules without [ijcasereportsandimages.com]

  Fine Needle Aspiration Cytology (FNAC) was performed from subcutaneous nodules on the left leg using a 21-gauge needle. [ijdvl.com]

  2017/28/1/194/198278 To the Editor, A 68-year-old woman on long-term intermittent hemodialysis (HD) for end-stage renal disease (ESRD) secondary to hypertension presented with three subcutaneous nodules around the metatarsophalangeal joints of both hands [sjkdt.org]

• Cutaneous Manifestation

  Clinical cutaneous manifestations of chronic gout are now rarely observed. However, the presence of degenerative tissues, as in idiopathic osteoarthritis of the fingers, may predispose to the deposition of urate crystals. [link.springer.com]

  manifestations of an infectious process. [ncbi.nlm.nih.gov]

  The cutaneous manifestations of gout are represented by intradermal lesions or subcutaneous nodules called tophi, commonly seen in avascular tissue over the ears, olecranon and prepatellar bursae or in acral sites, often associated with tendons. [cureus.com]

• Cervical Cord Compression

  Joint Bone Spine. 2013, 80:550-551. 10.1016/j.jbspin.2013.02.003 Sanmillan Blasco JL, Vidal Sarro N, Marnov A, Acebes Martin JJ: Cervical cord compression due to intradiscal gouty tophus: brief report. [cureus.com]

  Cervical cord compression due to intradiscal gouty tophus: brief report. Spine. 2012;37(24):E1534–6. Article PubMed Google Scholar Lui TH. Acute posterior tarsal tunnel syndrome caused by gouty tophus. [link.springer.com]

  Tophaceous gout in the cervical spine. Skeletal Radiol 2005; 34 : 803–806. 9. Sanmillan Blasco JL, Vidal Sarro N, Marnov A, Acebes Martin JJ. Cervical cord compression due to intradiscal gouty tophus. [nature.com]

• Clonus

  Neurological examination showed that his lower limb strength had decreased (Grade 4/5) on the left and he had left ankle clonus. The lower abdominal and cremasteric reflexes were normal. [nature.com]

We would like to highlight here the difficult diagnostic workup in a patient with history of cancer and the presence of a tophus inside the liver. [ncbi.nlm.nih.gov]

Laboratory workup revealed elevated serum uric acid (96 mg/l, normal: 20-74 mg/l), with normal renal function test. [panafrican-med-journal.com]

(See Presentation and Workup.) Robert Wadlow, 19 years of age, with his father (postcard photo prior to 1937). Courtesy of Wikimedia Commons (https://commons.wikimedia.org/wiki/File:Robert_Wadlow_postcard.jpg). [medscape.com]

Treatment Treating tophi is often part of a comprehensive gout treatment plan, and includes uric acid-reducing medications and lifestyle changes such as weight management and a diet low in foods that contain purines, such as veal, mussels, tuna, bacon [verywellhealth.com]

He was diagnosed with advanced erosive tophaceous gout and was given febuxostat treatment to reduce uric acid concentrations. After a month of treatment, uric acid concentrations fell to 578 μmol/L. [thelancet.com]

In our case, the patient’s gouty tophus had persisted for several years, despite treatment with allopurinol. [cureus.com]

Treatments with antibiotics and nonsteroidal antiinflammatory drugs were ineffective. However, prednisolone therapy was highly effective, and the patient's symptoms were rapidly ameliorated. [ncbi.nlm.nih.gov]

Without treatment, tophi may develop on average about ten years after the onset of gout, although their first appearance can range from three to forty-two years. [en.wikipedia.org]

[…] surrounds fluffy (cotton candy-like) material), fibrotic synovium Site joints - classically large toe Associated Dx +/-chronic renal failure, +/-diabetes mellitus Clinical history usually male Symptoms joint pain Prevalence common Blood work urea elevated Prognosis [librepathology.org]

Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognosis relevance of subclasification.J Clin Oncol. 2001; 12: 3045-3050 Pahwa P. McDuffie H.H. Dosman J.A. Robson D. McLaughlin J.R. Spinelli J.J. et al. [jprasurg.com]

Prognosis The prognosis is good for patients who are diagnosed and treated early. Only when left untreated is FGD a disease with high morbidity (neurological sequelae) and mortality. [orpha.net]

Treatment and prognosis Treatment of gigantism can be challenging, as transsphenoidal surgery (which is considered first line therapy) often does not control growth hormone levels 1. [radiopaedia.org]

Moreover, we address the possible etiologic role of chronic inflammation related to tophi and liver cancer. [ncbi.nlm.nih.gov]

To be familiar with the etiology, pathogenesis, histopathology, clinical presentation, and clinical course of tophaceous gout. OBJECTIVES 1. [medicine.tamu.edu]

Etiology:[2] Overproduction of uric acid ~ 10% of cases. Reduced excretion of uric acid ~ 90% of cases. May be genetic, e.g. URAT1 mutation.[3][4] Renal failure. Treatments:[5] NSAIDs. Allopurinol. Colchicine - prophylatic. [librepathology.org]

Crystal arthritides - gout and calcium pyrophosphate arthritis: part 1: epidemiology and pathophysiology. Z Gerontol Geriatr. 2017. DOI: 10.1007/s00391-017-1197-3. [Crossref], [Web of Science ®], [Google Scholar] ]. [tandfonline.com]

Clinical and epidemiological research Methods of tophus assessment in clinical trials of chronic gout: a systematic literature review and pictorial reference guide Nicola Dalbeth1, Cameron Schauer1, Patricia MacDonald2, Fernando Perez-Ruiz3, H Ralph Schumacher4 [ard.bmj.com]

Epidemiology:[1] Male (Females relative risk ~ 0.1). Renal failure. Diabetes mellitus. Etiology:[2] Overproduction of uric acid ~ 10% of cases. Reduced excretion of uric acid ~ 90% of cases. May be genetic, e.g. URAT1 mutation.[3][4] Renal failure. [librepathology.org]

Epidemiology Sex: : ♂ > ♀ (3:1) Age of onset: 30–60 years Prevalence: ∼ 8 million people in the US Higher incidence in African Americans References:[1][2] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Pathophysiology[edit] It appears that monosodium urate crystals trigger a distinct physiological NETosis pathway that coats them in DNA. [en.wikipedia.org]

Crystal arthritides - gout and calcium pyrophosphate arthritis: part 1: epidemiology and pathophysiology. Z Gerontol Geriatr. 2017. DOI: 10.1007/s00391-017-1197-3. [Crossref], [Web of Science ®], [Google Scholar] ]. [tandfonline.com]

This process and the cell death associated with NETs (NETosis) likely evolved as a cellular strategy to counteract pathogens, but although scientists generally agree that it plays an important role in pathophysiology, they have found it difficult to quantify [the-rheumatologist.org]

[…] and neutrophils followed by chronic gouty arthritis with tophi in joints and urate nephropathy Causes 2 - 5% of chronic joint disease Sites 50% have initial attack in first metatarsophalangeal joint; also ankles, heels, knees, wrists, fingers, elbows Pathophysiology [pathologyoutlines.com]

Large tophi should be removed to prevent any damage to your joint or loss of its range of motion. [healthline.com]

These medicines can prevent attacks of gouty arthritis and prevent MSU crystals from being deposited in the tissues. [dermnetnz.org]

The nasal bone defect was repaired with a titanium mesh plate to prevent nasal depression. He has fully recovered with no more nasal obstruction or recurrence of nasal tophus. [ncbi.nlm.nih.gov]

[See figure in the PDF file] Early diagnosis and prompt treatment can prevent severe crippling. [journals.lww.com]