“This is a radiograph of the left foot, AP View. Showing punched out periarticular erosion of the first metatarsal-phalangeal joint, periarticular swelling with preserved joint space. There is positive cloud sign showing increased soft tissue volume and density. Positive Martel sign – overhanging edge of bone, no fractures or dislocation is seen. Overall there is localized increased soft tissue volume and density on the first metatarsal-phalangeal joint localized. The parabola is within normal limits.
My impression is… Chronic Tophaceous gout of the fist metatarsal-phalangeal joint, left foot. I would like to test clinically to solidify my findings.”
Answer: Chronic Tophaceous gout/ Gouty Arthritis