MR imaging of tophaceous gout revisited.

Gout is the most common form of microcrystalline arthropathy, and does not usually pose a diagnostic challenge when patients have a typical presentation, appropriate biochemical picture and classical radiographic appearance. However, magnetic resonance (MR) imaging is increasingly used as the first-line imaging modality in patients with first presentation of joint pain or mass, and tophaceous gout is frequently a forgotten differential diagnosis. This article serves to review the MR imaging characteristics and appearance of gouty tophi in various joints, their clinical presentations and complications, as well as the common differential diagnoses.