| Patients with long-standing gout may have tophi over the olecranon prominence, first metatarsal joints, or pinnae. |
| Chalky deposits called tophi may appear under the skin around joints and in the cartilage of the ears. |
| Only a minority of patients with hyperuricemia develops tophi and gouty arthritis. |
| Crystal deposits may also build up under the skin around the joints and behind the ears, causing small lumps known as tophi and, in a few cases, in the kidneys. |
| The second child, a daughter, was club-footed and early suffered from gouty tophi. |
| While usually not painful, tophi can become swollen and tender during flare-ups of gout. |
