case_images: PMC6477753_01
case_images: Preoperative clinical sign showed trigger-like symptom and locking of the
  metacarpophalangeal joint of the left middle finger. Gouty tophus was
  deposited under the skin of the fingertip.
case_images: 10.1177_2050313X19844708-fig1.jpg
case_images: PMC6477753_01_10.1177_2050313X19844708-fig1.jpg
case_images: fig1-2050313X19844708
case_images: A 63-year-old man complained at our outpatient department of a sudden inability to extend the middle finger of his right hand (Figure 1).
case_images: Radiograph and CT of the metacarpal head of the middle finger showing that
  the radial condyle tip had a sharp osteophyte.
case_images: 10.1177_2050313X19844708-fig2.jpg
case_images: PMC6477753_01_10.1177_2050313X19844708-fig2.jpg
case_images: fig2-2050313X19844708
case_images: Radiographs and computed tomography (CT) showed ulnar deviation of the left fingers and osteophytes on the radial lateral aspects of the metacarpal head of the right middle finger and osteoarthritic change of the distal radioulnar joint (Figure 2).
case_images: Intraoperative aspect of the flexor superficialis tendon of the middle finger
  showing the mass filled with a chalky white substance.
case_images: 10.1177_2050313X19844708-fig3.jpg
case_images: PMC6477753_01_10.1177_2050313X19844708-fig3.jpg
case_images: fig3-2050313X19844708
case_images: With carpal tunnel release, flexor digitorum superficialis (FDS) tendon and flexor digitorum profundus (FDP) of the middle finger were found with multiple involved white lesions (Figure 3).
case_images: Histopathological evaluation of a section of resected tissue showing an
  eosinophilic amorphous gouty tophus deposit like needles surrounded by
  chronically inflamed cells, multinucleated giant cells, and fibrillations
  (hematoxylin-eosin stain 10x).
case_images: 10.1177_2050313X19844708-fig4.jpg
case_images: PMC6477753_01_10.1177_2050313X19844708-fig4.jpg
case_images: fig4-2050313X19844708
case_images: Histological findings confirmed the diagnosis of gout (Figure 4).