Cytological Diagnosis of Chronic Topaceous Gout without Clinical Arthritis

Multiple subcutaneous periarticular nodules can be because of various causes which include rheumatoid nodules, ganglion cysts, pigmented villonodular synovitis, synovial chondromatosis and synovial sarcoma [5]. Gouty tophus is also an important differential diagnosis. Clinically its diagnosis can be difficult in cases of unusual presentations in the absence of arthritis and / or hyperuricemia. A minority of individuals particularly elderly patients taking diuretics or corticosteroids are known to present with tophi without acute arthritis[10]. Fine needle aspiration cytology (FNAC) can act as an initial valuable and cost effective tool in diagnosis of gouty tophi as soft tissue nodules.