Soft Tissue Case 4 History/Physical Exam

Gout

Pain can be excruciating. Sometimes it is so painful that patients cannot bear weight and even the touch of a bed sheet is painful . Gout can predispose to septic arthritis so be wary of systemic symptoms such as fevers and pain that doesn't respond to traditional therapy. The classic exam finding is a swollen erythematous bursa over the 1^st MTP joint. Chronic gout can leave urate deposits called tophi of the olecranon bursa, Achilles, tendon, ulnar forearm, hands, fingers, knees, feet, toes and helix of the ear.