Gouty tophi most often occur at joints and adjacent soft tissues. Tophi can also be found at extra-articular sites.
Patient selection: gout
Musculoskeletal sites:
(1) bursa including popliteal cyst
(2) tendons (Achilles tendon, other)
(3) intra-muscular deposits (lower extremity, gluteal region)
(4) carpal tunnel
Tophi in the dermis or subcutaneous tissue include
(1) deposits in finger pads
(1) milarial gout (small papules)
(1) isolated subcutaneous nodule
(1) disseminated cutaneous gout
Other sites:
(1) nose
(2) pinna of the ear
(3) vocal cords and/or larynx
(4) bronchus
(5) cardiac valve
(6) breast
(7) cirrhotic liver nodule
(8) panniculitis
(9) male genital system (scrotum, testis, penis)
(10) pacemaker pocket, sites of other implants
(11) inguinal canal
Imaging studies performed for another reason may detect asymptomatic tophi in unexpected places.
