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June 25, 1938


Author Affiliations

Associate Professor of Surgery, Northwestern University Medical School; Chief Surgeon, Evanston Hospital; Evanston, Ill.

JAMA. 1938;110(26):2149. doi:10.1001/jama.1938.62790260001008

Gout is doubtless more prevalent than is commonly believed, yet the presence of tophi that simulate other lesions is quite rare. Out of a total of 24,766 admissions to the medical wards of the Peter Bent Brigham Hospital from 1913 to 1924 there were forty-four cases of gout.1 In Hench's series of 100 cases from the Mayo Clinic, proved tophi were found in forty-one.

While tophi may be found in many locations, they have, according to Monroe,2 a peculiar affinity for the ears. In this location he found them in 90 per cent of his cases. Tophi of the heels resembling pyogenic lesions are extremely uncommon.

REPORT OF CASE  B. H., a man aged 61, a blacksmith, came to our office in the fall of 1937 complaining of discharging lesions on the heels and pain in the heels associated with these sores. Examination of the heels revealed on