Int J Med Health Sci. January 2012,Vol:1;Issue:1 31 International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net Chronic Tophaceous Gout K.V.S. Hari Kumar* 1 , V. Marwaha 2 1 Department of Endocrinology, Command Hospital, Lucknow -226002.U.P. India. 2 Department of Rheumatology, Command Hospital, Chandimandir -134107. Haryana. A 44 year old man presented with a 15-day history of painful swelling of right middle finger, which was also red, warm, and tender. A tooth paste like, chalky substance was expressible on pressure from the swelling. The patient reported that he had occasional episodes of joint pains involving both small and large joints of the extremities. He denied a history of medication intake and past history of nephrolithiasis. -------------------------------------------------------------------------------------- Key Words: Chronic Gout, Tophi, Hyperuricemia ------------------------------------------------------------------------------------- *Corresponding author: Dr. K.V.S. Hari Kumar Email: hariendo@rediffmail.com Clinical examination revealed normotensive individual with multiple tophi over olecranon process, fingers and thumb with chalky white material (Figure1:) and on the extensor surface of the feet (Figure 2:). Figure 1: Gouty tophi with white chalky substance at periphery Images in Medicine