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Rationale:
- Other types of arthritis may be accompanied by subcutaneous nodules, most commonly rheumatoid arthritis, sarcoidosis, and
osteoarthritis. Other entities that may produce subcutaneous nodules and should be distinguished from gout include rheumatic
fever, chloromas, erythema nodosum, panniculitis, metastatic tumors, lupus profundus, and foreign bodies or foreign substances
injected under the skin.
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Evidence:
- Some patients have tophi as the presenting physical finding. This finding may be peculiar to elderly women taking diuretics
in whom tophi may develop in the Heberden's nodes (osteoarthritis of distal interphalangeal joint) or finger pads (29; 30).
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Comments:
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Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for
continuing medical education grand rounds and lectures given.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2010 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Gout
> Diagnosis
