Tophi are chalky, gritty accumulations of uric acid crystals that
build up in the soft tissue of a gouty joint, often occurring in the elbow or
the joints of the fingers or toes. Tophi develop if gout is not treated for an
extended period of time.
When tophi are located just under the skin, they are usually firm
and movable. The overlying skin may be thin and red. Tophi that are very near
the surface of the skin may appear cream-colored or yellow. If gout progresses
without treatment, tophi may form in the cartilage of the external ear or the
tissues around the joint (bursae, ligaments, and tendons), resulting in pain,
swelling, redness, and warmth (inflammation). Progressive crippling and
destruction of cartilage and bone is possible. Fortunately, advances in the
early treatment of gout have made this stage of gout uncommon.
Anne C. Poinier, MD - Internal Medicine & Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
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