Gout

Clinical History: 
This 56-year-old female presented to clinic complaining of right foot pain and swelling for the last year, particularly involving the base of the fifth metatarsal and the 3rd toe. A hard, painful nodule involving the base of the patient’s fifth metatarsal was noted on physical exam.

Diagnosis:
Tophaceous gout

MR Technique: 
Scans were acquired on a Siemens 1.5 T Espree MR unit. Sequences obtained included (A) coronal spin echo T1-weighted (TR/TE 750/11 ms, scan time 2:02 min:sec, slice thickness 3.5 mm) and (B) turbo spin echo fat-suppressed T2-weighted (TR/TE 4120/65 ms, scan time 1:18 min:sec, slice thickness 3.5 mm) images.

Imaging Findings:
Multiple cortical erosions within the tarsal and metatarsal bones, particularly along the first metatarsal head and the base of the fifth metatarsal, are present. Small soft tissue masses are associated with these erosions, the former appearing of homogeneously low signal intensity on T1 and intermediate signal intensity on T2-weighted images. No associated bone marrow edema is present.