Original MICA image-reading exercise, unscored. No clinical narrative absent from the source is added.
- Describe visible findings before proposing an interpretation.
- Suggest an interpretation and at least one image limitation.
- Which clinical findings or investigations would complement this observation?
Reveal the explained reading
Tophi: periarticular deposits
- Lesion
- Clinically suspected tophus
- Site
- Fingers and great toe
- Confirmation
- Crystals when diagnosis is uncertain
- Pitfall
- Coexisting infection is possible
Morphological description
The source documents tophaceous gout. The panel shows finger and great-toe swellings, with pale areas beneath the skin.
Causes and diagnostic direction
Previous joint attacks and hyperuricaemia support the interpretation. Crystal identification in a sample provides confirmation when needed.
Differential diagnoses
Rheumatoid nodules, calcinosis and osteoarthritic nodes may enter the differential. Location, consistency and context matter more than colour alone.
Pitfalls and limitations
Serum urate alone does not identify a nodule. The photograph does not establish current activity or adequacy of disease control.
Take-home message
Combine the deposit pattern, joint history and appropriate confirmation; consider infection when a lesion is inflamed.
Sources
- NICE NG219 — Gout: diagnosis and management (2022) ↗
- Arthritis Research UK Primary Care Centre, Keele University (E. Roddy) — document iconographique original / original image ↗
Documentary review: 2026-10-16
Media source & rights
- Author
- Arthritis Research UK Primary Care Centre, Keele University (E. Roddy)
- Original source
- Arthritis Research UK Primary Care Centre, Keele University (E. Roddy) — Tophaceous_gout.jpg — CC BY 2.0
- Licence
- CC BY 2.0
- Changes
- Main image converted to lossless WebP, EXIF orientation applied and metadata removed. Full field, colours and annotations retained; proportional thumbnails without upscaling or clinical retouch. Original media licence retained.
- Dimensions
- 512 × 353 px
- Check
- 2026-10-16