Tophi

Tophi are deposits of monosodium urate crystals that are a result of long-term high levels of uric acid in the blood, a condition known as hyperuricemia. They are a characteristic feature of gout, a type of inflammatory arthritis. Tophi are most commonly found in the elbow, knee, and around the toe joints. They can also occur in the ear, heart, and kidney.

Signs and Symptoms

Tophi are usually painless, but they can become tender and inflamed during gout attacks. They can also cause deformity and limit joint movement. In severe cases, tophi can erode the skin and cause infection.

Causes

Tophi are caused by the accumulation of uric acid in the blood. This can occur due to a diet high in purines, excessive alcohol consumption, certain medications, and genetic factors. Kidney disease can also increase the risk of developing tophi, as the kidneys are responsible for removing uric acid from the body.

Diagnosis

Tophi are diagnosed through physical examination and medical history. Blood tests can measure the level of uric acid in the blood. Imaging tests such as X-rays, ultrasound, and CT scans can also be used to detect tophi. In some cases, a sample of the tophus may be taken for microscopic examination.

Treatment

Treatment for tophi involves managing the underlying gout. This includes lifestyle changes such as a low-purine diet and limiting alcohol consumption. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids can help manage gout attacks. Medications that lower uric acid levels, such as allopurinol and febuxostat, can prevent the formation of new tophi and reduce the size of existing ones. In severe cases, surgery may be required to remove large tophi.

See Also

• Gout
• Hyperuricemia
• Kidney disease
• Purine

Tophi Resources
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