Gout Causing Isolated Sesamoid Destruction Mimicking a Neoplastic Process

The hallux metatarsophalangeal joint (MTPJ) is a common location affected by gouty inflammatory arthritis. Generally, this condition is successfully treated with medication and regular surveillance. Occasionally, gout can lead to advanced arthritic changes and chronic discomfort of the hallux MTPJ, necessitating surgical intervention to help alleviate symptoms. Rarely is the condition isolated to the sesamoid bone, which may lead to a diagnostic dilemma in patients without a history of gout. We report the case of a patient in whom isolated sesamoid changes associated with gout mimicked an aggressive neoplastic process.