# Severe tophaceous gout in the setting of myelofibrosis: A clinical challenge

## TL;DR

A patient with myelofibrosis presented with symptoms resembling infection, but was found to have severe gout, highlighting a rare clinical scenario.

## Contribution

Highlights an atypical presentation of tophaceous gout in a patient with myelofibrosis.

## Key findings

- Imaging suggested infection in a patient with myelofibrosis.
- Surgery revealed extensive tophaceous gout instead of infection.
- This case emphasizes the need to consider gout in myelofibrosis patients with similar symptoms.

## Abstract

We illustrate a case of a patient with a history of myelofibrosis, presenting with a clinical picture of presumed infection. Imaging revealed apparent fluid collections and erosions in the ankle/foot, supporting the clinical suspicion of infection. However, operative findings revealed extensive tophaceous gout, likely a consequence of long-standing myelofibrosis. It is important to be aware of this atypical presentation of gout in patients with myelofibrosis.