9: Chronic Tophaceous Gout
Gout results from uric acid buildup in your blood. Uric acid normally gets removed from your blood through your renal system in urine, but your diet or certain conditions can make it hard for your body to excrete uric acid. In this case, uric acid builds up around joints.
Tophi can form in any of the following body parts:
- Achilles tendon
Types of tissues where uric acid most commonly builds up to form tophi include:
- tendons that connect joints to muscles
- cartilage around your joints
- synovial membranes that line your joint cartilage
- any soft tissues in your joints, such as fat or ligaments
- bursae, small sacs that create a cushion-like barrier between bones and other soft tissues
Tophi can also form in connective tissue that isn’t found in a joint. Some of these locations include:
- sclerae, better known as the “whites” of your eyes
- renal pyramids, which are triangular-shaped parts of your kidneys made up of ducts and nephrons that help absorb nutrients before releasing waste as urine
- heart valves, such as the aorta
This can arise if gout is left untreated and the effects extend all over the body. For this to develop, it normally takes 10 years. At this point, the joints, skin, and soft tissues grow rough nodules that are known as tophi that also grow in one’s ears. This stage causes irreversible harm, and that is why addressing gout at earlier stages is highly important as it keeps the body safe from all chronic pain.