What are characteristics of erosions typically found in gout?

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

Erosions with overhanging edges generally are considered pathognomonic for gout but also can be found in amyloidosis, multicentric reticulohistiocytosis, and type IIA hyperlipoproteinemia. Characteristics of erosions that are typical of gout but not of rheumatoid arthritis include the following:

  • Maintenance of the joint space [102, 103]

  • Absence of periarticular osteopenia

  • Location outside the joint capsule

Another characteristic of erosions typical of gout is sclerotic borders, sometimes called cookie-cutter or punched-out borders. In addition, erosions in gout may be distributed asymmetrically among the joints, with strong predilection for distal joints, especially in the lower extremities (see the images below).

Gout. Plain radiograph showing typical changes of Gout. Plain radiograph showing typical changes of gout in first metatarsophalangeal joint and fourth interphalangeal joint.
Gout. Plain radiograph showing chronic tophaceous Gout. Plain radiograph showing chronic tophaceous gouty arthritis in hands.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!