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Chronic Gouty Tophi

After years of gouty attacks, patients will develop a chronic arthritis resulting in bone and cartilage destruction and deformity. Uric acid crystals deposit within and surrounding the joint causing a chronic destructive inflammatory process. X-rays characteristically show well demarcated "punched out" erosions.
Tophi at helix of ear.
 Tophi or deposits of uric acid crystals are often found around joints, in the olecranon bursa or at the pinna of the ear.

X-ray showing soft tissue swelling and erosion of 2nd PIP.

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