Stephen Bird

Hi Diane,

This stinks of gout,

It smells of gout so much I can smell it from all the way over the other side of the Nullabor plain.

I think you have synovitis, some small crystals and some tophus.

A history of gout would clinch it,

But even if they have not had known gout I still think this is gout,

It is the correct location as well.

They could test the uric axis blood levels,

Also a joint synovial fluid aspiration can be performed and the sample sent to the lab for luminescence crystal testing.

Dual energy CT is another possibility.

Nice example,


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