Gout is brought about deposition of solidified or crystallized uric acid sediments most commonly in the lower extremities brought about by increased levels of uric acid. An elderly patient (67 years old) previously diagnosed with gouty arthritis came in with a chief complaint of severe pain on the foot.
Gouty arthritis has 4 stages:
(1) Asymptomatic hyperuricemia
(2) Acute gout attack
(3) Intercritical gout
(4) Chronic tophaceous gout
Lower extremity examination of gout patients in in stages 2-3 will reveal edema, redness, and extreme of the involved foot. In stage 4 gout, along with edema, redness, and tenderness; there will be the presence of white to yellow deposits called tophus (plural; tophi) usually in the medial side of the big toe.
