The Challenges of Approaching and Managing Gout

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The Challenges of Approaching and Managing Gout Theodore R. Fields, MD Rheumatic Disease Clinics Volume 45, Issue 1, Pages 145-157 (February 2019) DOI: 10.1016/j.rdc.2018.09.009 Copyright © 2018 The Author(s) Terms and Conditions

Fig. 1 Microscopic demonstration of tophaceous material. (A) Image of patient’s thumb interphalangeal joint with whitish material with surrounding erythema, with no history of gout. (B) Image of polarizing microscopic view of material from surface of thumb interphalangeal joint showing negatively birefringent monosodium urate crystals diagnostic of gout. Rheumatic Disease Clinics 2019 45, 145-157DOI: (10.1016/j.rdc.2018.09.009) Copyright © 2018 The Author(s) Terms and Conditions

Fig. 2 Classic tophi. This patient has classic appearance of tophi, including irregular shape, whitish material seen under the skin of the distal second toe, and first toe shows overlying increased vascularity. Rheumatic Disease Clinics 2019 45, 145-157DOI: (10.1016/j.rdc.2018.09.009) Copyright © 2018 The Author(s) Terms and Conditions