case_images: PMC3515934_01
case_images: (a and b) Multiple nodules overlying deformed joints seen in the hand of a chronic patient with tophaceous gout.
case_images: JCIS-2-68-g002.jpg
case_images: PMC3515934_01_JCIS-2-68-g002.jpg
case_images: F1
case_images: Some lesions had ulcerated discharging white chalky material [Figures 1a and b].
case_images: Soft tissue radiograph of hand shows swelling and arrows point to bone erosion.
case_images: JCIS-2-68-g003.jpg
case_images: PMC3515934_01_JCIS-2-68-g003.jpg
case_images: F2
case_images: Radiographic evaluation of both hands showed soft-tissue swelling and periarticular erosions in the lower end of radius and interphalangeal joints with sclerotic margins and overhanging edges [Figure 2].
case_images: Transthoracic echocardiogram in apical 4 chamber view: Arrow points to a hyperechoic, oval-shaped mass on the mitral valve.
case_images: JCIS-2-68-g004.jpg
case_images: PMC3515934_01_JCIS-2-68-g004.jpg
case_images: F3
case_images: Transthoracic echocardiogram showed a hyperechoic, oval-shaped mass measuring 1.5 x 1 x1 cm on posterior mitral leaflet not reducing significantly the opening area of the valve (3.0 cm2), but he had trivial mitral regurgitation [Figure 3].