Tophi vs Bone spur. Or is it gout?

[BelieveInScience]

Gout or Bone Spur

Hello all,
My brother may be following in my gouty footsteps. I am attempting to help him diagnose his condition and chart a plan of action, using all the good information here. Yes, we are testing his UA.

He has a small lump on his foot that gets the flares. He claims to have had it x-rayed in the past, and diagnosed as a bone spur. I find this suspicious. Have any of you ever run into a misdiagnosis of tophi as a bone spur? Further, do you think it possible to mistake it even under an x-ray?

Thanks in advance for any thoughts.

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Do you know why your big toe is red, swollen, and painful?

[zip2play]

It’s a tough call from the OUTSIDE, but an X-ray clearly shows a bone spur in sharp contrast, like other bones and a tophus as “fuzziness.”
Location plays a part as well, for example a lump sticking out the back of a heel is usually a spur. A non-pointy lump at the bunion joint is usually a tophus. A POINTY lump is usually a BUNION.

Fingers are especially tough becasue tophi and the nodes of osteoarthrits look pretty similar.

X-rays are misread every day and I’m sure some hands were even misdiagnosed as FEET.

And history can help. For example, If you’ve had 3 gout attacks and you see a new lump, odds are VERY good it’s gout.

[BelieveInScience]

Thanks Zip.

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