Gout

- Radiographs:

- in the hand look for oval periarticular erosions;

- multiple erosions will be distributed throughout the carpi and phalanges bilaterally;

- erosions have sclerotic borders and will often have overhanging edges;

- unlike classic RA, in early gout, hand and wrist joints will have preserved joint spaces and normal mineralization;

- example: - case of histologically proven gout involving the proximal 5th metatarsal: (see above foot image).