By Dr Irwin Lim, Rheumatologist
I'll let you have a guess. One of the most common causes of inflammatory arthritis.
When a rheumatologist sees this, the diagnosis is obvious.
Gout.
Specifically, tophaceous gout. It takes years to grow these lumps.
Typically, gout causes painful, swollen joints. High levels of uric acid in the blood lead to uric acid crystals precipitating in joints, and episodically, this leads to joint inflammation. Over time, the joints become more permanently damaged and the uric acid crystals deposit in the kidneys, and in the skin.
What constantly surprises me is how some patients still seem to be able to let the disease progress to this point. Gout is not a silent disease.
In fact, it is a terribly painful disease in its early phases. It's been called the disease of kings and the king of diseases.
It's also reasonably easy to treat. The aim is to lower the uric acid level in the blood and when adequate suppression is achieved, the disease is typically very well controlled.
The difficult part is usually patient compliance.
Do you know patients who still suffer with gout?
Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.