Gout Crystals in Thumb

December 19, 2020

Gout Crystals in Thumb is my featured image for Thumb Tophi.

The following quote is taken from the article in which this photograph appeared.

A 70-year-old man sought medical attention for a white lesion with surrounding erythema on the thumb of his right hand. The lesion had been present for many years and had recently become inflamed and painful. He had no other symptoms. […]
The lesion was lanced, and the fluid removed was examined under polarized light microscopy. Analysis revealed negatively birefringent urate crystals, which confirmed the diagnosis of gout. Results of blood tests showed a serum uric acid level of 8.5 mg/dL (normal, 3.5 to 7.2 mg/dL). […]
This patient was successfully treated with oral colchicine. Certain lifestyle modifications (avoidance of high-purine foods and alcohol in excessive amounts) were suggested. He has had no further thumb discomfort.

In some patients, long-term therapy with a serum uric acid–lowering agent, such as probenecid or allopurinol, may be required.

Please see my thumb tophi page for some explanations. Though I cannot explain how this mistreatment happened. Or why this Gout Victim failed to get the uric acid treatment he so clearly needed.