Disabling gout The Lancet Volume 376, Issue 9746, (September 2010) AK Tausche, MD, I Panzner, MD, D Aust, MD, C Wunderlich, MD  The Lancet  Volume 376, Issue 9746, (September 2010) DOI: 10.1016/S0140-6736(10)60135-3 Copyright © 2010 Elsevier Ltd Terms and Conditions

Figure Signs, radiographic images, and histology of severe gout (A) Swollen 1st metatarso-phalangeal joint and hallux valgus (arrow). (B) Foot radiography showing boney destruction of 1st metatarsal (arrows). (C) T1 weighted MRI of foot showing gouty tophus (arrow). (D) Surgical excision of gouty tophus (arrow). (E) Haematoxylin and eosin stain showing boundary between crystals and inflammatory cells (asterisks). (F) Filtered polarised light microscopy showing monosodium urate crystals. The Lancet 2010 376, DOI: (10.1016/S0140-6736(10)60135-3) Copyright © 2010 Elsevier Ltd Terms and Conditions