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Tophus ( Greek  τοφιών = tuff ; plural tophi ) or knot describes an inflammatory knot formation in medicine . In a narrower sense, the term is used to describe tissue deposits of uric acid (usually in the form of monosodium urate ) in the subcutaneous tissue and other connective tissue areas as well as in the bones, which are then referred to as Tophus arthriticus ("gout nodule"). They are specific to gout .

Soft tissue phus

Soft tissue phi are usually multiple, the size of a pinhead to a pea, and sometimes larger. Particular locations are ears, less often hands, feet, elbows, tendons , tendon sheaths and bursa . They are sharply delimited, coarse to grainy, yellow to chalky in color, usually painless. They can occasionally ulcerate .

Bone entophus

Bone entophi are multiple, round or oval tophi with mostly sharp borders (“punched out”), sometimes also blurred. They can be central, cortical , or close to the joints, then also destroying the cortex. The preferred location is the epiphyses of the finger and toe joints.


The conservative treatment of gout enough usually to bring tophi disappear. If this does not work (for example if the medication is taken unreliably) or if a tophus constricts the spinal cord , in the case of carpal tunnel syndrome or an impending tendon rupture, an operative procedure in terms of tophus reduction should be considered.


  • Roche Lexicon Medicine. 5th edition. Urban & Fischer, Munich, Jena 2003, ISBN 3-437-15150-9 .
  • Deutsches Ärzteblatt 2003; 100: A 2862-2870 [Issue 44]

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