Gout Information

Topheous gout

In the case of an untreated sufferer who over a period of approximately ten years has experienced intermittent attacks of acute gout, a more chronic arthritis slowly develops in which symptoms will not completely resolve between attacks. The urate crystals responsible for acute attacks - which are generally only visible under a microscope - collect together beneath the skin to form a lump called a tophus. Tophi typically appear at the rim of the ear (where they are seen as small firm nodules), in the upper surfaces of the fingers, hands and feet and in the forearms and Achilles tendons. They can even grow in the kidney, severely compromising its filtering mechanisms.

Topheous gout commonly causes deformity and joint immobility. In fact in the days before treatment was available, tophi could grow larger than a golf ball - particularly on the hands and feet -and render the individual unable to function. The tophi might even discharge a white chalky substance. (It is said that this was once used by some teachers to write on blackboards - what better example could there be of the grossness of gout in the past!) Furthermore, tophi would often become ulcerated and discharge blood and