Chronic Gouty Dactylitis

Abstract

Figures

A](#fig1)). Laboratory findings confirmed hyperuricemia and elevated inflammatory markers, including a C-reactive protein level of 4.2 mg/dL (reference, 0.0-0.3). X-rays of his hands showed erosions and a soft-tissue mass in the left fourth finger ([Figure 1B](#fig1)). A diagnosis of an acute gout flare was established. The patient was treated with nonsteroidal anti-inflammatory drugs.

Full text

A 57-year-old man with a ten-year history of untreated gout presented with acute right ankle pain. Physical examination revealed multiple tophi involving the joints and subcutaneous tissues of his limbs, non-tender diffuse swelling of the fourth digit of his left hand, and arthritis of the right ankle (Figure 1A). Laboratory findings confirmed hyperuricemia and elevated inflammatory markers, including a C-reactive protein level of 4.2 mg/dL (reference, 0.0-0.3). X-rays of his hands showed erosions and a soft-tissue mass in the left fourth finger (Figure 1B). A diagnosis of an acute gout flare was established. The patient was treated with nonsteroidal anti-inflammatory drugs.

In long-standing uncontrolled gout, monosodium urate crystals can deposit around tendons and phalanges, manifesting as chronic dactylitis ^(1), (2)^. The reported prevalence of dactylitis in gout is low, ranging from 5% to 10% ^(1)^. The presence of chronic dactylitis may suggest severe disease, with more tophi and involved joints, higher serum uric acid concentrations, and longer disease duration ^(2)^.

Article Information

Author Contributions

Data acquisition and manuscript drafting: Hiroshi Shiba. Manuscript review and supervision: Takahiro Asano, and Masato Okada.

Conflicts of Interest

None

Informed Consent

We have obtained informed consent for this manuscript.

Approval by Institutional Review Board (IRB)

In this study, IRB approval was not required.