Professor Nicola Dalbeth, MD
Auckland, New Zealand

Professor Nicola Dalbeth, MD Professor Nicola Dalbeth, MD Professor Nicola Dalbeth, MD

THE CORRELATION BETWEEN TOPHI AND BONE EROSION IN GOUT

Prof. Nicola Dalbeth, MD explains how untreated tophi can cause a chemical imbalance that may lead to bone erosion and severe joint damage. Watch video

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THE EXTENT OF TOPHUS-INDUCED JOINT DAMAGE

Prof. Nicola Dalbeth, MD discusses tophi, focal cartilage loss, and the relationship between tophus size and erosion size. Watch video

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BOTH LARGE AND SMALL TOPHI CAN CAUSE JOINT DAMAGE1,5-8

Computed tomography scans of hands (serial axial view) from Professor Nicola Dalbeth, MD’s study show areas of bone erosion with radiographic erosion scores of 5 caused by both large and small tophi.1

Serial axial view of hands Large tophus Bone erosion (radiographic erosion score of 5)Serial axial view of hands Large tophus Bone erosion (radiographic erosion score of 5)Serial axial view of hands Large tophus Bone erosion (radiographic erosion score of 5)

Serial axial view of fingers Small tophus Bone erosion (radiographic erosion score of 5)Serial axial view of fingers Small tophus Bone erosion (radiographic erosion score of 5)Serial axial view of fingers Small tophus Bone erosion (radiographic erosion score of 5)

Images adapted with permission from Dalbeth N. Ann Rheum Dis. 2009;68(8):1290-1295.1

Tophi, even if they’re not acutely inflamed and causing severe pain at that very moment, have a number of really important consequences for patients.

– PROFESSOR NICOLA DALBETH, MD

Images adapted with permission from Dalbeth N. Ann Rheum Dis. 2009;68(8):1290-1295.1

IN ADDITION TO BONE EROSION, TOPHI CAN LEAD TO FOCAL, POTENTIALLY LONG-TERM LOSS OF CARTILAGE9

In a study of more than 229 tophus sites, readers found a correlation between tophus size and cartilage abnormalities.9*

Cartilage Loss MRICartilage Loss MRICartilage Loss MRI

*P<0.005
Image adapted with permission from Popovich I, et al. Skeletal Radiol. 2014;43(7):917-924.9

Cartilage loss really occurs at the site of the tophus, rather than more diffusely within the entire joint.

– PROFESSOR NICOLA DALBETH, MD

*P<0.005
Image adapted with permission from Popovich I, et al. Skeletal Radiol. 2014;43(7):917-924.9

GET MORE INFORMATION ABOUT THE CURRENT STATE OF GOUT RESEARCH

Additional resources

AMERICAN COLLEGE OF RHEUMATOLOGY (ACR) GUIDELINES FOR MANAGEMENT OF GOUTAMERICAN COLLEGE OF RHEUMATOLOGY (ACR) GUIDELINES FOR MANAGEMENT OF GOUT

AMERICAN COLLEGE OF RHEUMATOLOGY (ACR) GUIDELINES FOR MANAGEMENT OF GOUT

Is your sUA goal low enough to effectively reduce the signs and symptoms of gout and resolve tophi? Review the 2012 ACR guidelines to see if your gout treatment goals line up with industry recommendations.

CELLULAR CHARACTERIZATION OF THE GOUTY TOPHUS: A QUANTITATIVE ANALYSIS

ENHANCED OSTEOCLASTOGENESIS IN PATIENTS WITH TOPHACEOUS GOUT

To better understand the mechanisms behind bone erosion in gout, Professor Nicola Dalbeth, MD and her team examined the relationship between increased numbers of osteoclasts at erosion sites and the presence of urate crystals.

CELLULAR CHARACTERIZATION OF THE GOUTY TOPHUS: A QUANTITATIVE ANALYSIS

CELLULAR CHARACTERIZATION OF THE GOUTY TOPHUS: A QUANTITATIVE ANALYSIS

Professor Nicola Dalbeth, MD’s 2010 article in Arthritis & Rheumatology details her team’s study of the cellular architecture of tophi, and how the cells present in the corona and fibrovascular zones of a tophus may contribute to a cycle of chronic inflammation.

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TAKE A DEEPER LOOK AT GOUT

View a comprehensive collection of curated medical images to see the full scope of damage that tophi can cause.

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WHAT YOU CAN DO

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  • Dalbeth N, et al. Ann Rheum Dis. 2009;68(8):1290-1295.
  • Schett G, et al. RMD Open. 2015 Aug 15;1(suppl 1):e000046.
  • McQueen FM, et al. Rheumatology (Oxford). 2014;53(1):95-103.
  • Dalbeth N, et al. Ann Rheum Dis. 2015;74:1030-1036.
  • Doghramji PP, et al. Postgrad Med. 2012;124(6):98-109.
  • Yu KH, et al. Rheumatology (Oxford). 2004;43(2):191-194.
  • McQueen FM, et al. Rheumatology (Oxford). 2014;53(1):95-103.
  • Desai MA, et al. RadioGraphics. 2011;31(5):1365-1375.
  • Popovich I, et al. Skeletal Radiol. 2014;43(7):917-924.