Abstract
A 61-year-old male patient with a 13-year history of untreated gout presented to our hospital with pain in the left knee. Physical examination revealed inflammatory changes in the left knee, large subcutaneous nodules in bilateral first metatarsophalangeal joints, and enlargement of the left Achilles tendon. Despite treatment for gout with allopurinol elsewhere during the last five years, the large subcutaneous nodules had progressed. His serum uric acid level was 5.9 mg/dL, and his C-reactive protein level was elevated (5.82 mg/dL).
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