Gouty arthritis

Acute gouty Arthritis

Podegra
• Deposition of monosodium urate crystal (MSU) at first metatarsophalangeal joint
• overlying skin is red ,shiny with marked swelling.
 Chronic tophaceous gout
• firm nodules (tophi) formed due to Large MSU crystal deposit
• the usual sites for nodules are around the extensor surfaces of the fingers ,
hand , forearm ,elbow , helix of the ear and Achilles tendon.
• Nodules may ulcerate.
• It has whitish color

Tophi on fingers
joints
 Chronic tophaceous gout

Tophi on Achilles tendon

A) Tophi On proximal interphalangeal joint of hand

B) Tophi On distal interphalangeal joint of foot
Chronic tophaceous gout
helix of ear
Chronic tophaceous gout
elbow
 Behcet‘s disease
• Oral ulcers are universal , unlike aphthous ulcers, they are usually deep and
multiple, and last for 10–30 days.

• Genital ulcers are also a common problem, occurring in 60–80% of cases.

• The usual skin lesions are erythema nodosum or acneiform lesions,

• Ocular involvement is common and may include anterior or posterior uveitis

or retinal vasculitis.
 A) oral ulcer
Oral ulcer B) genital ulcer
Anterior uveitis and hypopyon Erythema nodosum
Reactive arthritis
A( oral ulcer in the hard palate
painless
B) Acute anterior uveitis and
conjunctivitis
C) Keratoderma blenorrhagicum
 Keratoderma blenorrhagicum
• is papulosequamous rash most commonly affecting the palms and soles
Circinate balanitis
is usually painless.
Rheumatic fever
Erythema marginatum Subcutaneous nodules