TY  - JOUR 
TI  - Severe deformans tophaceous gouty arthritis
PB  - Elsevier
PY  - 2017
issn 1297-319X
AB  - A 61-year-old man with a 20-year history of gout with severe functional disability was evaluated in our service. He received alopurinol and colchicine without response. Physical examination revealed bilateral great deformity, multiple tophi and edema of hands (Fig. 1), feet and knees. Serum uric acid was elevated: 11.2 mg/dL (reference value: 3.4–7.0 mg/dL). Hands X-ray AP view demonstrated, in both hands (Fig. 2A [left] and B [right]), conserved bone mineralization with severe soft-tissue swelling, extensive erosions with sclerotic borders (white arrows), precipitation of calcium with urate crystals giving density to the tophi (head arrows), bone spiculations (black arrows) and osteolytic expansive lesions in multiple heads of metacarpophalangic joint (double-head arrows).
KW  - Ciencias  socio biomédicas
KW  - Medical sciences
KW  - Discapacidad
KW  - Artritis de gota
KW  - Artritis degenerativa
KW  - Dermatología
UR  - http://hdl.handle.net/10906/81411
ER  -