Joint Pain & Dermatological Findings

Abstract

A 78-year-old African American male presents to his primary care office with a minimally tender mass on the lateral aspect of his 2nd digit. His history was negative for fever, chills, and trauma to the area. He endorsed joint pain diffusely with multiple episodes on podagra in the past. The tender mass had started 4 weeks prior to presentation with increased swelling of a new minimally tendermass on the digit, which has since progressed to Figure 1. With growth of the mass patient now complains of slight numbness and cold sensation in the involved fingertip. The patient takes NSAIDs for joint pain that he states does relieve some of the discomfort associated with the mass. His past medical history is significant for hypertension, which he takes Losartan and hydrochlorothiazide, hyperlipidemia, osteoarthritis, and gout, for which he does not take prophylactic medication.

When palpated the joint demonstrated firmness rather than fluctuance and there was no purulent material with attempted incision and drainage. The mass was aspirated and viewed under microscopy as seen in Figure 2 and 3.