A man who has had gout for several years comes to the clinic with a "problem with my toe." On examination,the nurse notes the presence of hard,painless nodules over the great toe;one has burst open and released a chalky discharge.This finding is known as:

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Tophi are collections of sodium urate crystals due to chronic gout in and around the joint that cause extreme swelling and joint deformity.They appear as hard,painless nodules (tophi)over the metatarsophalangeal joint of the first toe,and they sometimes burst with a chalky discharge.

A Man Who Has Had Gout for Several Years Comes