Note 29 — Chapter XVI · CLINICAL ACCOUNT

Redness of the skin overlying a developing tophus is not invariable. In a case recently under my care, the dorsum of the mid-phalangeal joints was the seat of small soft localised swellings. The superjacent skin was unchanged in colour. Aspiration of the contents by a hypodermic syringe disclosed the presence of a turbid white fluid, which, when microscopically examined, was found loaded with the acicular crystals of sodium biurate.