What is the typical presentation of tophi in gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Tophi are classically located along the helix of the ear, but they can be found in multiple locations, including the fingers, the toes, the prepatellar bursa, and along the olecranon, where they can resemble rheumatoid nodules (see the images below). Rarely, a creamy discharge may be present. [86, 87] The finding of an apparent rheumatoid nodule in a patient with a negative rheumatoid factor assay or a history of drainage from a nodule should prompt consideration of gout in the differential diagnosis. [88]

Gout. Tophaceous deposits in ear. Gout. Tophaceous deposits in ear.
Gout. Tophaceous deposits on elbow. Gout. Tophaceous deposits on elbow.
Gout. Chronic tophaceous gout in untreated patient Gout. Chronic tophaceous gout in untreated patient with end-stage renal disease.

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