3 inflamed tophi over the proximal interphalangeal joints in a patient with tophaceous gout. Several of the lesions ruptured spontaneously over the next 3 days, exuding a pasty material composed of monosodium urate (MSU) crystals and inflammatory cells but no organisms. The inflammation largely subsided over 1 week after the administration of a nonsteroidal antiinflammatory drug.
