Gouty arthritis

Radiograph of the left hand demonstrating features consistent with gouty arthropathy. There are juxta-articular punched-out erosions and intraosseous cystic lesions, most prominent at the index proximal interphalangeal (PIP) joint and distal ulna. There is joint space loss suggesting underlying cartilage loss at the fifth finger PIP joint and soft tissue swelling due to a subcutaneous tophus at the index finger PIP joint. Vascular calcifications of distal forearm and hand vessels are also evident.