Related Experiment Video
Updated: Jul 9, 2026

Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
Published on: June 21, 2024
Diagnostic dilemmas in unusual presentations of gout
Christopher Hoe-Kong Chui1, Jonathan Yi-Liang Lee
1Department of Hand Surgery, Singapore General Hospital, Singapore. chkchui@gmail.com
Background:
Gout is known to mimic conditions as diverse as joint and soft tissue infections, skin malignancies, nerve compression syndromes and soft tissue tumours. Upper limb involvement is unusual.
Objective:
We discuss four cases of gout in the hand and wrist masquerading as a soft tissue tumour, nodular extensor tenosynovitis, septic arthritis of the wrist and acute and chronic median nerve compression. These cases illustrate that gout in the hand and wrist can resemble more sinister conditions, often posing a diagnostic challenge even to the experienced clinician.
Discussion:
In the management of hand and wrist pain, swelling and neuropathy, emphasis must be placed on actively excluding limb and life threatening conditions such as septic arthritis and neoplasia. Laboratory and radiological investigations cannot accurately distinguish these pathologies from gout. Invasive surgical exploration or tissue sampling is often needed to establish the correct diagnosis.
Related Concept Videos
Urinary Tract Calculi III: Medical Management
Acute Pyelonephritis II: Diagnostic Studies and Management
Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Urinary Tract Calculi V: Nursing Management