Chronic tophaceous gout manifesting with bilateral diffuse pedal swelling: Cytology revisited with an update in its list of differentials

Gout, a disorder of purine metabolism, presents with acute or chronic arthritis and deposition of urate crystals in connective tissue and kidneys. Rarely, patients progress into chronic tophaceous gout (CTG). We emphasize on a 74-year-old male patient, who developed multiple gouty tophi over both his hands. In addition, both his feet were diffusely swollen. On detection of characteristic urate crystals from both his hands and feet lesions, the diagnosis of CTG was confirmed.