Tophus: Difference between revisions
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{{Infobox medical condition | |||
| name = Tophus | |||
| image = [[File:Tophaceous_gout_of_Lt_MTP_joint,_elder_female_patient,_Thailand.jpg|left|thumb|Tophus on the left metatarsophalangeal joint]] | |||
| caption = Tophus on the left metatarsophalangeal joint | |||
| field = [[Rheumatology]] | |||
| synonyms = Gouty tophus | |||
| symptoms = [[Joint pain]], [[swelling]], [[deformity]] | |||
| complications = [[Joint destruction]], [[ulceration]], [[infection]] | |||
| onset = Typically after years of [[hyperuricemia]] | |||
| duration = Chronic | |||
| causes = [[Gout]], [[hyperuricemia]] | |||
| risks = [[High purine diet]], [[alcohol consumption]], [[obesity]], [[renal insufficiency]] | |||
| diagnosis = [[Physical examination]], [[imaging studies]], [[synovial fluid analysis]] | |||
| differential = [[Rheumatoid nodule]], [[lipoma]], [[epidermoid cyst]] | |||
| prevention = [[Dietary modification]], [[medication]] to lower [[uric acid]] levels | |||
| treatment = [[Medication]], [[surgery]] | |||
| medication = [[Allopurinol]], [[febuxostat]], [[colchicine]], [[nonsteroidal anti-inflammatory drugs]] | |||
| frequency = Common in individuals with chronic gout | |||
}} | |||
Tophus is a deposition of subcutaneous deposition of [[uric acid]] seen in advanced '''[[gout]]'''. | Tophus is a deposition of subcutaneous deposition of [[uric acid]] seen in advanced '''[[gout]]'''. | ||
[[File:Tophus achille talon.jpg|alt=Tophus achilles tendon|thumb|Tophus achilles tendon]] | [[File:Tophus achille talon.jpg|alt=Tophus achilles tendon|left|thumb|Tophus achilles tendon]] | ||
== Symptoms == | == Symptoms == | ||
Chronic tophi gout cause [[joint deformity]] and [[limitation]] of [[motion]] in affected joints may occur if several attacks of gout occur each year. | Chronic tophi gout cause [[joint deformity]] and [[limitation]] of [[motion]] in affected joints may occur if several attacks of gout occur each year. | ||
<youtube> | <youtube> | ||
title='''{{PAGENAME}}''' | title='''{{PAGENAME}}''' | ||
movie_url=http://www.youtube.com/v/fmCOk6O5IY0 | movie_url=http://www.youtube.com/v/fmCOk6O5IY0 | ||
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</youtube> | </youtube> | ||
[[File:Gouty tophus - very high mag.jpg|alt=Gouty tophus|thumb|'''Gouty tophus''']] | [[File:Gouty tophus - very high mag.jpg|alt=Gouty tophus|left|thumb|'''Gouty tophus''']] | ||
== Locations == | == Locations == | ||
[[Uric acid]] deposits called tophi develop in [[cartilage]] tissue, [[tendon]]s, and [[soft tissue]]s. | [[Uric acid]] deposits called tophi develop in [[cartilage]] tissue, [[tendon]]s, and [[soft tissue]]s. | ||
Deposits also can occur in the kidneys, leading to chronic renal failure. | Deposits also can occur in the kidneys, leading to chronic renal failure. | ||
== Etiology == | == Etiology == | ||
A tophus (Latin: "stone", plural tophi) is a deposit of monosodium urate crystals, in people with longstanding high levels of uric acid in the blood, a condition known as [[hyperuricemia]]. | A tophus (Latin: "stone", plural tophi) is a deposit of monosodium urate crystals, in people with longstanding high levels of uric acid in the blood, a condition known as [[hyperuricemia]]. | ||
[[File:Gouty tophi on the elbow Wellcome L0062317.jpg|alt=Gouty tophi on the elbow|thumb|Gouty tophi on the elbow]] | [[File:Gouty tophi on the elbow Wellcome L0062317.jpg|alt=Gouty tophi on the elbow|left|thumb|Gouty tophi on the elbow]] | ||
== Clinical pearl == | == Clinical pearl == | ||
Tophi are pathognomonic for the disease [[gout]]. | Tophi are pathognomonic for the disease [[gout]]. | ||
== Pathophysiology == | == Pathophysiology == | ||
Without treatment, tophi may develop on average about ten years after the onset of gout, although their first appearance can range from three to forty-two years. | Without treatment, tophi may develop on average about ten years after the onset of gout, although their first appearance can range from three to forty-two years. | ||
== Treatment == | == Treatment == | ||
* When uric acid levels and gout symptoms are usually controlled with standard gout medicines such as [[colchicine]] or | * When uric acid levels and gout symptoms are usually controlled with standard gout medicines such as [[colchicine]] or | ||
* Medications that decrease the production of uric acid (e.g., [[allopurinol]], [[febuxostat]]) | * Medications that decrease the production of uric acid (e.g., [[allopurinol]], [[febuxostat]]) | ||
* Other medicines that increase uric acid elimination from the body through the kidneys such as [[probenecid]]) can also be used | * Other medicines that increase uric acid elimination from the body through the kidneys such as [[probenecid]]) can also be used | ||
[[Category:Gross pathology]] | [[Category:Gross pathology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
{{stub}} | {{stub}} | ||
[[Category:Gross pathology]] | [[Category:Gross pathology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
Latest revision as of 21:01, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Tophus | |
|---|---|
| Synonyms | Gouty tophus |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Joint pain, swelling, deformity |
| Complications | Joint destruction, ulceration, infection |
| Onset | Typically after years of hyperuricemia |
| Duration | Chronic |
| Types | N/A |
| Causes | Gout, hyperuricemia |
| Risks | High purine diet, alcohol consumption, obesity, renal insufficiency |
| Diagnosis | Physical examination, imaging studies, synovial fluid analysis |
| Differential diagnosis | Rheumatoid nodule, lipoma, epidermoid cyst |
| Prevention | Dietary modification, medication to lower uric acid levels |
| Treatment | Medication, surgery |
| Medication | Allopurinol, febuxostat, colchicine, nonsteroidal anti-inflammatory drugs |
| Prognosis | N/A |
| Frequency | Common in individuals with chronic gout |
| Deaths | N/A |
Tophus is a deposition of subcutaneous deposition of uric acid seen in advanced gout.
Symptoms[edit]
Chronic tophi gout cause joint deformity and limitation of motion in affected joints may occur if several attacks of gout occur each year.
Locations[edit]
Uric acid deposits called tophi develop in cartilage tissue, tendons, and soft tissues. Deposits also can occur in the kidneys, leading to chronic renal failure.
Etiology[edit]
A tophus (Latin: "stone", plural tophi) is a deposit of monosodium urate crystals, in people with longstanding high levels of uric acid in the blood, a condition known as hyperuricemia.
Clinical pearl[edit]
Tophi are pathognomonic for the disease gout.
Pathophysiology[edit]
Without treatment, tophi may develop on average about ten years after the onset of gout, although their first appearance can range from three to forty-two years.
Treatment[edit]
- When uric acid levels and gout symptoms are usually controlled with standard gout medicines such as colchicine or
- Medications that decrease the production of uric acid (e.g., allopurinol, febuxostat)
- Other medicines that increase uric acid elimination from the body through the kidneys such as probenecid) can also be used
