Findings

Note that the first metatarsophalangeal joint (big toe) is markedly swollen and red. Such a lesion is very painful and tender to the touch.

Impression

Gouty arthritis

Clinical Pathologic Correlation
In most cases, clinical episodes begin abruptly with severe pain and tenderness in the affected joint. The initial attacks usually resolve followed by an asymptomatic period. If untreated, the disease will recur and eventually cause permanent joint injury.

Pathology Pointer

Gouty arthritis is caused by the accumulation of uric acid in the tissue due either to overproduction or reduced excretion. Although any joint may be involved, the following joints are affected commonly: great toe (90%), instep, ankle, heel and wrist.

View

Clinical photograph

Specimen

Foot

Image Credit

Dr. Michael Weisman
Department of Medicine
School of Medicine
University of California, San Diego