Ultrasonographic Presentations of Tophi-like Masses at Atypical Locations

Gout is an inflammatory disease that is caused by a cellular reaction to the crystal deposition of uric acid. Tophi often appear in patients with hyperuricemia and chronic and recurrent attacks of gouty arthritis. It commonly deposits in the feet, ankles, knees, hands, wrists, and elbows. We present three cases of gouty arthritis with tophi-like mass found at the suprapatellar bursa, toes, and gluteal area using ultrasonography. All the masses presented as cauliflower-like structures of hyperechogenicity or heterogeneous hyperechogenicity in the affected areas. We concluded that ultrasonography is an effective, noninvasive and low-cost method for detecting tophi-like masses at atypical locations before diagnostic surgery.