case_images: PMC7276575_01
case_images: Hand and feet deformities due to tophi in the patient.
case_images: JOCR-10-66-g001.jpg
case_images: PMC7276575_01_JOCR-10-66-g001.jpg
case_images: F1
case_images: On presentation, the patient was not able to carry out the basic activities of daily living due to severe deformities of the hands and feet including holding a spoon or hairbrush due to tophi (Fig. 1). On physical examination, flexion deformities of the metacarpophalangeal joints (Fig. 1), and proximal and distal interphalangeal joints of all fingers and toes were noted along with tophi.
case_images: Tophi in index finger surgically excised.
case_images: JOCR-10-66-g002.jpg
case_images: PMC7276575_01_JOCR-10-66-g002.jpg
case_images: F2
case_images: He underwent tophi excision in the left index finger (Fig. 2), olecranon, and right toe in July 2014.
case_images: Tophi seen in helix.
case_images: JOCR-10-66-g003.jpg
case_images: PMC7276575_01_JOCR-10-66-g003.jpg
case_images: F3
case_images: Tophi also noted on the helix of both ears (Fig. 3), elbows, and heel.
case_images: Typical radiographical "cookie cutter" appearance in knees.
case_images: JOCR-10-66-g004.jpg
case_images: PMC7276575_01_JOCR-10-66-g004.jpg
case_images: F4
case_images: X-ray of hands showed evidence of asymmetrical joint narrowing and typical calcified tophi and bone erosions sclerosis and the "cookie cutter/rat bitten" appearance of bones (Fig. 4 and 5).
case_images: Appearance of tophi as soft tissue swelling on ankle radiographs.
case_images: JOCR-10-66-g005.jpg
case_images: PMC7276575_01_JOCR-10-66-g005.jpg
case_images: F5
case_images: X-ray of hands showed evidence of asymmetrical joint narrowing and typical calcified tophi and bone erosions sclerosis and the "cookie cutter/rat bitten" appearance of bones (Fig. 4 and 5).
case_images: Healing wound on heel after surgical excision.
case_images: JOCR-10-66-g006.jpg
case_images: PMC7276575_01_JOCR-10-66-g006.jpg
case_images: F6
case_images: Febuxostat was continued and dressing was done till the wound healed (Fig. 6).