Recent patient case complains of chronic pain and swelling in the foot with an inability to walk on concrete and waking at night, resistant to the medication.

Gout is an inflammatory arthritis and any joint can be involved in gout, but the first MTP joint is the most common.

Classic x-ray findings of gout consists of juxta-articular and intra-articular erosions with sclerotic margins and overhanging edges. bone density is normal. Tophi can be seen as soft-tissue dense masses adjacent to the joints in chronic stages of the disease.