Tophus (Tophi)

A tophus (tophi when used in the plural form) is a large deposit of uric acid crystals in the body. They show up in people who have hyperuricemia (high levels of uric acid in the blood) that has turned into the disease called gout, which is when needle-like uric acid crystals deposit themselves into the body's joints, tissue and tendons. Usually when tophi form, a person’s gout has progressed to a stage called chronic tophaceous gout (also called Harrison Syndrome). About 25% of gout sufferers will develop tophi. 

Tophi generally form in the joints, bones and cartilage throughout the body. Common places include the toes, elbows, knees, ankles, fingers and ears. They can also appear in the kidneys and nose. 

Tophi usually appear about 10 years after a gout diagnosis, but they can pop up at any time. They are generally painless in the beginning and show themselves in the form of a visible lump in the joint. Sometimes tophi group together and grow large enough that they break through the skin. In some cases, the lumps grow so big that they must be amputated in order for the body to function regularly. Therefore, it is important to not ignore tophi when they first begin to form. 

Diet and increased water intake can help prevent tophi from forming, but usually medication and/or surgery is needed to keep them at bay. The drug Krystexxa can help quickly shrink tophi, as can Uloric. 

Ways to help prevent tophi include following a diet low in purines (avoiding seafood, steak and alcohol), drinking plenty of water, engaging in regular physical activity, refraining from tobacco use and following your doctor’s recommendations.