Gout physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2].

Physical Examination

Physical examination findings may include the following:

• Joint inflammation: Involvement of a single or multiple joints during an acute gout attack will show joint inflammation (synovitis), tenderness, erythema, swelling, and warmth of the affected joint. 25777045
• Fever: Features of systemic inflammation, including fever, might also be present, particularly in the presence of a polyarticular flare. 21288096
• Tophi: The subcutaneous deposition of MSU crystals as tophi may be found on the fingers, olecranon processes, toes, Achilles’ tendons, knees and occasionally on the helix of the ears. 224473446
• Ocular findings: MSU crystal deposition has been reported to occur in various parts of the eye. Crystal deposition in the cornea may cause peripheral ulcerative keratitis, while retinopathy may be associated with chronically uncontrolled gout. 29053564 29351793

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  Gout flare affecting first metatarsophalangeal joint
• 
  Tophus on Achilles’ tendon
• 
  Tophi on ear. Note the associated inflammation