{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:14:11Z","timestamp":1788156851130,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Gout is a metabolic condition in which hyperuricaemia leads to deposition of monosodium urate (MSU) crystals in synovial and peri\u2010articular tissues. (1) Acutely, synovial deposition causes a painful inflammatory reaction. Over time, chronic hyperuricaemia can lead to deposition of uric acid crystals in alternate tissues, with granulomatous inflammatory responses forming gouty tophi. Chronic tophaceous gout affects approximately 3% of gout patients and presents as a spectrum from classical nodular tophi to rarer disseminated manifestations such as miliarial gout, panniculitis and ulcerative cutaneous gout. (2) This case details the management of a Maori patient in his 40s, presenting with acute infection of extruding gouty tophi across his lower limbs, managed with antibiotics, surgical debridement and oral urate\u2010lowering therapy. Multiple secondary complications of gout were identified during his care, including involvement of tendons and nerves in gouty deposits (with rare involvement of forearm extensor tendons), early onset polyarticular osteoarthritis with joint destruction and osteopenia. This case demonstrates the widespread effects of this disease and a range of complications secondary to poorly controlled tophaceous gout.<\/jats:p>","DOI":"10.1002\/ccr3.73263","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T05:21:31Z","timestamp":1786166491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disseminated Chronic Tophaceous Gout With Multi\u2010Tissue Involvement"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0923-7445","authenticated-orcid":false,"given":"Yee Leng","family":"Loh","sequence":"first","affiliation":[{"name":"Stroke and Rehabilitation Services Ipswich Hospital  Ipswich Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Combe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland  Brisbane Queensland Australia"},{"name":"General Medicine Department Ipswich Hospital  Ipswich Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.2310\/7750.2007.00002"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2015.01.002"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208237"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.91"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2020.136925"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/91.2.190"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-009-0258-x"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2012.03.007"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.5070\/D3211025437"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13764"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.14763"},{"key":"e_1_2_14_13_1","article-title":"Imaging Appearances in Gout","volume":"2013","author":"Girish G.","year":"2013","journal-title":"Art"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex442"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.12788\/cutis.0760"},{"key":"e_1_2_14_16_1","unstructured":"(NICE) NIfHaCE \u201cGout: Diagnosis and Management. Evidence Review for Surgical Excision of Tophi \u201d(2022)."}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73263","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73263","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:22:25Z","timestamp":1788153745000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ccr3.73263"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73263","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73263"}}