This 51-year-old man has a gouty tophus with no history of gouty arthritis. He visited our hospital with a subcutaneous mass at his right hallux metatarsophalangeal joint. Laboratory evaluation revealed no abnormal findings except for serum urate 9.3 mg/dl. On magnetic resonance (MR) images, the signal intensity of the mass (arrows) was nearly as isointense as that of muscle on Tl-weighted images (Upper row Fig. 1) and heterogeneous low to heterogeneous high (arrows) on T2-weighted images (Lower row Fig. 1). MR imaging also revealed osteolysis of the metatarsal head induced by the mass. Microscopic examination of the contents of the mass obtained by puncture revealed monosodium urate crystals (Fig. 2).
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