50 years old gentleman, came to us for periodic offshore(OGUK) medical check up.
Bilateral upper limbs – multiple tophi noted over both small phalangeal joints, wrist and elbow. This gentleman has limited range of movement over his both hands, with unable to flex his fist fully.
Lower limb – bilateral tophi over the podagra
He is a chronic alcohol drinker.
Back in 2022, his uric acid level was 0.64 mmol/L, and was started on Tablet Allopurinol 300mg OD.
Repeated uric acid level in 2023 showed slightly reduced – 0.53mmol/L.
Final Diganosis: Tophaceous Gout