Gout Initially Mimicking Rheumatoid Arthritis and Later Cervical Spine Involvement

Figure 2

Radiographs of hand (a), knee (b), foot (c), and ankle (d) showing severe destructive changes secondary to tophaceous gout with erosion, soft tissue swelling (tophi), articular space narrowing, and proliferative bone abnormalities. Note the well-defined extra-articular large erosions with overhanging margin and surrounding bone eburnation (arrows). The uniform joint space narrowing with normal bone density in knee and wrist is typical of late gout disease.

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