Tophaceous gout is a chronic, progressive manifestation of hyperuricemia characterized by urate crystal deposition in soft tissues and joints throughout the body. Although effective urate-lowering therapies exist, management can be challenging in patients with prior medical conditions such as renal insufficiency and chronic kidney disease. This often leads to medication intolerance with subsequent joint deformity and disability. Here, we present a 63-year-old man with severe, chronic tophaceous gout that has caused significant limitations. Despite years of treatment with various methods, this patient has yet to receive appreciable relief.
Weiderman et al. (2026) studied this question.