What are the typical radiographic features of gout?
Soft tissue swelling around the affected joint can accompany gout flare. In advanced gout, tophi and bony erosions can be seen. Articular tophi produce irregular soft tissue densities that are occasionally calcified, although urate/MSU is radiolucent in isolation. Bony erosions in gout appear “punched-out” with sclerotic margins and overhanging edges, sometimes described as rat bite erosions. In stark contrast to rheumatoid arthritis, the joint space is typically preserved until late in the disease and juxtaarticular osteopenia is absent.