Thumb Tophi - Worst Symptom of Thumb Gout

Thumb tophi join the collection of lumps on the hand for victims of tophaceous gout.

As you can see from the photograph below, a thumb tophus can be particularly debilitating if it stops you gripping effectively.

The one shown below is not the worst I’ve seen, but bad enough to make you think twice about leaving your uric acid level above 5 mg/dL.

Unfortunately, we do not have a corresponding photograph of the thumb after treatment, but almost all similar case studies show that the tophi dissolve if uric acid is maintained at a suitably low level. If you use the search boxes near the top and bottom of each page to search for lower faster, you will see that aiming for low uric acid is always a good idea when tophi are present.

Thumb Tophi Information

The photograph below is one of a series of seven gout pictures from “A Photo Essay of Gouty Arthritis” in Consultant Live^[1]. As this is not a regular gout case study, we do not have all the background. I have paraphrased the description of the photograph below, and you can see the original text if you click the photograph.

The thumb of a 70-year-old man shows a white patch surrounded by red inflammation.

The thumb was lanced, and fluid collected, which was analyzed under a microscope, revealing crystals. The crystals split polarizing light in a way that identified them as uric acid crystals. This confirmed a diagnosis of gout.

Results of tests showed a uric acid level of 8.5 mg/dL (0.51 mmol/L) in the blood. The original description refers to a normal range, which is meaningless. You will find information about why this is meaningless if you search for normal uric acid in the search box above or below.

Gout appears first in a single joint, for most gout patients. The essay mentions 70%, but there is no reference for this. Gout involving multiple joints is seen occasionally. This case, where gout is diagnosed despite no swollen joints, is rare.

Thumb Tophi Photograph

Gout Crystals in Thumb — Thumb Tophi with Gout Crystals

Thumb Tophi: Next Steps

In this example, the patch of gout crystals is very clear, presumably due to skin bursting at some point. Often, the tophi show as lumps of varying size. If you have unusual growths on your thumbs, you should consult your doctor immediately.

Many gout sufferers accept small lumps on their thumbs. Because they are usually painless and don’t restrict thumb movement. But that will change as they grow. So it is time to stop this symptom of excess uric acid. Before it grows so big that you need surgery. Now that you know this, how is delaying uric acid treatment going to help you?

Leave Thumb Tophi to browse the Tophi facts section. Or return to Step 3 of your GoutPal Plan for Gout Victims.

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Common Terms: dissolve, Most Helpful Gout Pages, thumb