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One of my patients, a 44 year old Torres Strait Islander patient with DM2 and history of gout and multiple joints damaged, knees, ankles has developed lumps in his Achilles. Although I had not seen or heard of it I suspected tophi. Ultrasound has supported my diagnosis (rare to them too).
So now. How can we help him? what is the prognosis? How do we manage/limit further damage?
He is one of amazing health workers.