Why is hygroma on the finger dangerous and how to get rid of it

Often young women are perplexed: where did the strange lump appear on their hand?

?
Although painless, but quite large (from 0.5 to 6 cm in diameter), it cannot go unnoticed due to its location. So what is hygroma
- cancer or a purely aesthetic defect?

Although hygroma on the arm is a tumor-like formation, it, contrary to misconceptions, is not an oncological disease

, and also
never degenerates into cancer
. This disease is quite widespread (up to 50% of all neoplasms on the hands) and can be successfully treated. On the other hand, this subcutaneous formation can cause discomfort or even interfere with normal blood circulation in the hands.

Hygroma

(or, as it is also called,
ganglion
) is a capsule-bag that is dense to the touch, filled with a viscous and jelly-like protein liquid mixed with fibrin. The hygroma noticeably protrudes over the ligaments and tendons and practically does not move under the skin. Most often, synovial cysts are observed in women aged 20 to 30 years (⅔ of the total number of patients). Children are least likely to suffer from it.

In what cases should you worry about treating hygroma and can it be prevented?

Hygroma - formation in the form of a tumor

What is hygroma

Hygroma is a benign neoplasm that affects the joint capsule and is formed from the same tissues that form the membranes of the joint. Essentially, it is a cyst filled with serous fluid, sometimes interspersed with mucus. Hygroma on the finger usually appears in the area of ​​the flexor (distal) joints and in the early stages looks like a ball on the skin. Subsequently, if left untreated, the cyst may begin to grow and in some cases grows to a sizeable size, at which the initially harmless ball under the skin begins to interfere with the fingers’ normal functioning.

Types of hygroma

As we mentioned above, hygroma can occur in the form of a single formation, delimited from other tissues by a membrane. It is also possible for several cysts to appear, fused or independent of each other.

However, most often the disease is classified according to the location of the lump. So, doctors distinguish the following types of it:

• hygroma of the wrist joint
  ;
• hand hygroma
  ;
• hygroma on fingers
  .

Much less common:

• hygroma of the knee joint
  (formed in the knee fossa, also known as Becker’s cyst);
• hygroma of the ankle joint
  ;
• hygroma of the foot
  (located on the dorsal, i.e., upper, side of the foot, usually at its outer edge).

The tendon ganglion, located in the wrist and hands, accounts for up to 88% of the total number of cases of the disease. The ankle joint and foot bothers up to 11% of patients who suffer from hygroma. A synovial cyst in the neck, shoulder, shoulder blade or knee occurs in only 1% of patients. It is extremely rare for patients to see a doctor with formations in the bones, muscles or spine.

Hygroma of the wrist

Hygroma of the wrist joint

- the most common type of synovial cyst. It becomes clearly visible in a bent position of the wrist joint (for visual diagnosis, you need to move the hand forward and back, and then left and right). Often, hygroma of the wrist joint is located on the front or back side of the joint, but it can also grow on the lateral surfaces or at the very base of the palm.

If the lump is located under the ligament, it may not cause any concern and may not even cause any aesthetic discomfort.

As a rule, the consistency of hygroma of the wrist joint is felt as soft or springy, “rubbery”.

Hygroma of the hand

Tendon ganglion in the hand area

(hygroma of the hand) usually occurs on the fingers (from the side of the palm), the palm itself, the back of the hand, or closer to the wrist joint. Typically, hand hygroma does not bother the patient until it reaches a large enough size and does not interfere with everyday activities.

Hygroma on the finger

Synovial cyst on fingers

often occurs on their back side, in the area of ​​the distal phalanx (i.e., the last one on which the nail is located). Often it is located in close proximity to the cuticle or nail fold.

The skin over the hygroma on the finger, as a rule, looks thinned, stretched, and its natural pattern is smoothed out. Under the skin, as a rule, a rounded formation can be easily felt, which does not cause pain, except in case of injury. It is quite dense to the touch, so it can be perceived as a bone or cartilage growth.

Hygromas on the palmar side of the phalanx are usually larger than on the back, and can spread to the entire phalanx and even occupy the adjacent one. They can be quite painful due to compression of the nerves that run along the sides of the fingers. This type of hygroma often prevents patients from performing household chores.

Ganglions also appear at the proximal phalanges

(near the base of the finger). Such cysts are also quite painful, despite their small (about the size of a pea) size. Pain with a hygroma on the finger usually occurs when trying to tightly grasp a hard object (for example, the handle of a shovel, a rolling pin, etc.).

Hygroma of the lower extremities

Synovial cysts of the lower extremities are typically localized on the back of the foot or fingers, as well as on the front of the ankle joint. Such hygroma rarely bothers patients with pain. As a rule, discomfort occurs when the foot is compressed by tight shoes, the foot is rubbed or stuffed, and also when the lump is located in close proximity to the nerve.

Hygroma of the lower extremities

What causes the disease

The reasons for the appearance of cystic neoplasms are not known for certain, however, regarding hygroma, doctors can identify several observations that are one way or another related to its manifestations.

Age.

The disease is more common in women than in men and predominantly affects young and middle-aged patients. Most often it occurs at the age of 20–30; cases of hygroma in minors or after forty are extremely rare and are considered an exception.

Excessive stress on fingers.

This disease often occurs in pianists, seamstresses, writers, people who write or type a lot from an early age - in a word, they work with their fingers and keep them under constant tension. The risk is especially great if the load is uneven and some fingers are strained more than others. This happens with knitters, artists and other types of professional activities.

Genetic factor.

Diseases associated with the musculoskeletal system are often provoked by hereditary predisposition, and hygroma is no exception in this sense: it appears much more often in those whose relatives also had a similar neoplasm.

Various damages.

Hygroma on the finger can develop as a consequence of injury: sprain, dislocation of the joint, and others. The disease also occurs due to inflammation of the ligaments and joint structures.

Possible complications of hygroma

Although hygroma is a disease with a positive prognosis and a relatively low risk of complications, it can lead to pathologies that require prompt surgical intervention

. First of all, this concerns painful or rapidly growing formations that can compress blood vessels and soft tissues and impair their trophism. This condition directly damages the bone and cartilage tissue in the hands, leading to starvation and degenerative changes in the wrist and interphalangeal joints, deterioration of muscle and ligament function, as well as fine motor skills of the fingers.

With an “unfortunate” location, the hygroma of the hand can compress veins and nerve bundles

, disrupting the conduction of nerve impulses in the hands, causing aches and severe pain after exercise. There is also a risk of traumatic crushing of the tumor.

In the worst case scenario, a large synovial cyst can cause:

• thrombophlebitis (inflammation of the venous wall with the formation of a blood clot, which leads to blockage of the vessel), venous stagnation (accompanied by swelling and cyanosis of the tissues around the hygroma);
• rupture of the hygroma’s own capsule, as well as blood vessels with hemorrhage;
• pinched nerves and disruption of the normal innervation of the hand, which is accompanied by numbness in the fingertips and tingling;
• bursitis and even purulent tendovaginitis;
• suppuration and sepsis if the wall of the hygroma bursts;
• contracture (persistent loss of mobility in the hand, finger or other affected parts of the body);
• re-development of benign formations (single or, more often, multiple) after injury or removal of hygroma.

If you encounter mechanical crushing of a hygroma on your hand, do not try to remove its contents yourself.

!
Treat the affected area with an antiseptic and apply a sterile bandage, then contact your surgeon within a few hours
.

Due to damage to the skin over the formation, infection of the tendon ganglion

(hygromas). The development of complications and the onset of the inflammatory process is indicated by:

• increase in general body temperature (up to 38-40°C);
• impaired mobility in the joint;
• changes in the structure of the skin over the hygroma (loss of elasticity, redness, roughness, peeling);
• soreness.

Treatment of hygroma in this case should be carried out by an orthopedist-traumatologist or surgeon. It is not worth leaving a crushed hygroma without treatment: after the capsule wall heals, it will fill with liquid again, and new formations may appear around it.

What does a hygroma look like?

Hygroma on the finger in the early stages looks like a small lump, a painless lump or growth in the joint area. It is dense to the touch, but not hard, and does not cause pain when pressed. The surface of the neoplasm is smooth, with smoothly defined boundaries; as a rule, it has a clear spherical shape. The hygroma is attached to the surrounding tissues on a pedicle and due to this is tightly fixed in one place - near the joint.

Symptoms of the disease

The intensity of the manifestations of the cyst depends on the stage of its development. At first, the tumor is so clinically featureless that the patient does not even notice it. But over time, as it grows, hygroma can become quite aggressive and cause a lot of unpleasant sensations. Typical signs of a tendon ganglion are:

• Pain in the joint area when the fibrous seal is compressed;
• Tumor growth to significant sizes - from 3 to 6 cm;
• Thickening and roughness of the skin at the site of the cyst;
• Redness of the epidermis during current inflammation;
• Very rapid tumor growth - literally in 1-2 days;
• The presence of a soft, elastic consistency;
• Slight impairment of joint mobility due to the influence of a growing cyst on it;
• Low-grade body temperature - from 37 to 38 C°.

In some cases, suppuration of the synovial fluid, severe weakness, aching joints and muscles, nausea accompanied by vomiting, biomotor paralysis, local edema and fainting may be observed, which indicates microbial damage to the cyst and the development of a septic process. This situation requires urgent medical attention.

How it manifests itself

• The tumor is filled with synovial fluid - the same substance that is normally found inside the joint, which explains its watery structure.
• Palpation of the hygroma does not cause pain: there are no nerve endings in the cyst, it is not inflamed by itself (however, it can be a concomitant disease with chronic joint diseases, as well as inflammation; in such cases, pain is quite possible).
• Initially, the ball under the skin is quite small and sometimes not immediately noticeable, although if localized on the finger it becomes visible quite quickly due to the specific location. Hygroma begins to grow with uncontrolled loads on the joint, in some cases - on its own.

Causes of hygroma of the wrist joint

Hygroma forms when a “weak spot” appears in the capsule, which occurs when it becomes thinner due to damage or changes in it.

The main reasons that can lead to this condition:

• Joint injury;
• Consequences of surgery;
• Persistent minor injuries to the hand (and joint) that occur as a result of repetitive activities, such as playing tennis;
• Inadequate physical activity on the arms and especially the hand.

What is important to pay attention to

The symptom that should alert you is pain. If a synovial cyst causes pain when pressed or moved, this indicates either a developing inflammatory process, or that during the growth of the hygroma it has compressed some tissues. As the formation grows, pain often occurs and is caused precisely by compression. In addition to this, the following symptoms are possible:

• the skin over the tumor becomes rough and rough;
• the lump itself grows, sometimes reaching 5 cm in diameter - for a hygroma on a finger, this is a fairly substantial size to seriously interfere with life;
• the mobility of the affected joint worsens, bending it becomes more difficult;
• in the presence of inflammation, swelling and redness of the tissues appear - typical inflammatory symptoms.

These signs indicate that the disease has become chronic and require specialist intervention. The doctor will help identify hygroma, distinguish it from manifestations of rheumatoid arthritis or other joint diseases, prescribe treatment and help get rid of the cyst forever.

Characteristics of the disease

Tendon ganglion is the second name for hygroma.
Conventionally, the anomaly is considered harmless, but capable of causing physical and psychological discomfort to the patient. The shape of the hygroma is spherical and at the initial stage it is small in size. However, as the tumor grows in diameter, it can reach very large dimensions. The volume of the ganglion capsules increases gradually, without causing any concern at first. If pain is felt during manual manipulation of the tubercle, for example, by pressing, this is a reason to immediately visit a doctor.

The tumor consists of an articular membrane filled with a clear protein liquid mixed with fibrin and mucus. The capsule is attached to nearby tissues and bone structures, which provides the tumor with reliable fixation at one point. To the touch, the hygroma is elastic, dense and very mobile, and when you press on its surface, you can even feel the small rice bodies inside it.

According to assumptions, the root cause of cyst formation is degeneration (metaplasia) of connective muscle, cartilage or bone tissue. The hygroma is located mainly in the tendon sheath and articular capsule.

Consequences

The neoplasm is not life-threatening: it does not malignize, that is, does not degenerate into malignant, does not destroy tissue by itself, and does not have manifestations that, in theory, can lead to death. However, finger hygroma in the later stages is extremely unpleasant, as it spoils the appearance, causes discomfort and, in some cases, pain and swelling, and interferes with normal mobility. If the synovial cyst goes side by side with inflammation, the symptoms only intensify, and the hand begins to function much worse than it could.

Diagnostic methods

Determining hygroma is not difficult, since the formation always has characteristic clinical signs. However, in order to exclude diseases with similar symptoms, differential diagnosis is carried out using standard research methods:

• Palpation of the site of the ganglion lesion and measurement of its parameters;
• Taking a cyst puncture;
• X-ray of the finger;
• MRI;
• Ultrasound of the growth;
• General laboratory tests - urine, blood, glucose levels, biochemical analysis, tests for hepatitis and sexually transmitted diseases.

If the hygroma is damaged

In some cases, hygroma may go away on its own. This happens quite rarely, and despite advertising, medications have little effect on this likelihood, but it can happen if you damage the lining of the cyst so that fluid leaks out of it. This is not recommended: it causes pain and often causes relapses, and can also cause injury to healthy tissue. In addition, damage to the hygroma is a recipe for complications, such as the penetration of infection into the capsule (if it is punctured or otherwise opened from the outside) or the contents of the cyst are pushed into the joint.

How to treat

Conservative ways of solving the problem have been practiced for a long time. The formation was kneaded, crushed, the liquid was removed from it through punctures, and sclerosing drugs were injected. They used therapeutic mud, ointments with an anti-inflammatory effect, and physiotherapy. However, only in 10% of cases was it possible to achieve a positive effect: in the rest, relapses occurred.

After scientists discovered the ability of degenerated hygroma cells to restart the process of tumor formation, the conservative methods were done away with. The only treatment today is surgical excision, after which not a single fragment of tissue remains. Therefore, if in the case of other formations it is possible to remove atheroma with a laser or radio wave method, then with hygroma you will have to trust the surgeon and go for surgery, although some doctors practice endoscopic techniques.

Intervention is simply necessary if the tumor progresses seriously, causes severe pain and limits movement in the joints. You shouldn’t turn a blind eye to the aesthetic side of the issue: a lump on the wrist is always a cosmetic defect. After its removal, performance is restored and a normal lifestyle is established, and if endoscopic intervention is chosen as an intervention, recovery time is significantly reduced.

Diagnostics

A subcutaneous tumor on the finger is easily determined visually, but in order to make an accurate diagnosis, the doctor must prescribe diagnostic measures. They will help exclude other diseases: arthritis, abscess, other types of neoplasms (lipoma, epithelial cyst, etc.). As a rule, during diagnosis, a general blood and urine test is taken from the patient, and an ultrasound is also prescribed. This set of measures is usually sufficient, but in complex cases (additional disease) a biopsy or MRI may also be recommended.

How dangerous is the disease?

Hygroma itself is harmless. However, if it is injured or improperly treated, various complications and the development of a local inflammatory process are possible. Among the likely consequences of ganglion:

• Spontaneous opening of the cyst and leakage of serous fluid into adjacent soft tissues or out;
• Pressing the tumor contents into the joint cavity;
• Metastasis and formation of multiple factions of the ganglion;
• Inflammation and suppuration at the location of the cyst - tenosynovitis, etc.

If you handle the tumor carelessly and neglectfully, the risk of infection is quite high. Therefore, when doing a manicure or working in the kitchen, you should eliminate the possibility of accidentally injuring the cyst and introducing infection into its cavity.

Conservative treatment

Medication and physiotherapeutic measures are needed to relieve inflammation that may accompany the development of hygroma, as well as to prevent its growth. They will not remove the cyst by itself: the doctor must warn you about this at the appointment.

Medication measures

Medicines prescribed for the disease include:

• anti-inflammatory drugs (non-steroidal, as well as glucocorticoids for severe inflammation);
• antibiotics (used only in situations where the cyst is injured from the outside, resulting in infection entering its cavity);
• antihistamines (also used for inflammation, relieve swelling and reduce the manifestations of inflammatory symptoms).

The doctor may also prescribe compresses with dimexide, a substance that is considered one of the main treatments for joint diseases. It is an anti-inflammatory, which at the same time has the ability to enhance the effect of other local medications (ointments, creams).

Physiotherapeutic measures

Physiotherapy prescribed for illness includes electrophoresis, mud therapy, paraffin and magnetic therapy. These measures are also aimed at reducing inflammation. If the cyst is not accompanied by an inflammatory process (this is easy to understand by the absence of pain), such measures will not give results, nor will taking medications.

Treatment of hygroma

Although sometimes a hygroma on the arm can be left without treatment, due to the risk of complications and aesthetic discomfort, doctors usually recommend its removal. Sometimes a synovial cyst can resolve spontaneously if the factor that provokes it (for example, occupational stress) is eliminated in a timely manner - then the synovial fluid will simply stop flowing into the capsule.

The indication for treatment of hygroma is its multi-chamber nature, rapid growth of formation, development of the inflammatory process, pain syndrome, and limited mobility in the joint.

The preferred treatment for hygroma is surgical removal.

, since puncture or aspiration of the tumor is usually ineffective or poses a risk of complications.
Thus, conservative treatment of wrist hygroma is characterized by recurrence of the disease in approximately 80-90% of cases
, while for surgical treatment the same figure is only
8-20%
.

Surgery

Doctors do not recommend delaying surgical treatment of hygroma, since a large, albeit benign, formation soon begins to displace blood vessels, muscles, ligaments and nerves. Their non-physiological position significantly complicates the operation and may have consequences for the patient

.

Removal of a hygroma on the arm is usually carried out under local anesthesia with a tourniquet and lasts no more than half an hour. The operation is performed using a scalpel or laser equipment. In advanced cases, large or unusual formations may require general anesthesia. When carrying out the procedure, it is important to remove all degenerative cells without exception (otherwise the altered tissue may again develop into a cyst), wash the capsule, and also bandage the so-called. the mouth of the hygroma, which is associated with the joint and feeds the lump with synovial fluid. The drainage tube for fluid drainage is removed 1-2 days after the procedure, and postoperative sutures after complete healing of the incision are removed on days 7-10. After this, it is recommended to immobilize the operated area with a splint and a pressure bandage for several weeks and avoid serious stress on it for 30-60 days.

.

Recently, surgeons have given preference to endoscopic removal of wrist hygroma, in which the capsule and its contents are removed through a small incision a couple of centimeters in size. Rehabilitation after such an intervention occurs much faster.

Conservative treatment of hygroma

As a conservative treatment for hygroma of the hand, crushing it (without penetration and formation of a wound) is occasionally used, followed by the application of a compressive bandage. This method should never be used on infected synovial cysts due to the risk of sepsis, but it can be used to treat sterile lumps. The main disadvantage of this approach is the rapid recurrence of the disease: as soon as the burst edges of the capsule grow together, it will again begin to fill with serous fluid.

A somewhat more successful technique is aspiration puncture of the formation, in which its contents are sucked out through a small puncture, and glucocorticoid solutions and sclerotization preparations are injected in its place. This allows the capsule to be filled with connective tissue instead of liquid. This method is also indicated for administering antibiotics and treating infected hygroma.

Conservative techniques do not eliminate degenerative cells

, which provoke the formation of hand hygroma and are therefore considered ineffective.

There are several methods for treating hygroma

Physiotherapy

A small cyst that does not grow, does not become inflamed and does not cause pain can often be treated conservatively using physiotherapeutic techniques. They help reduce the volume of formation and ensure the outflow of its contents, slow down cell growth. Although physiotherapy cannot completely cure hygroma, in combination with chondroprotectors

it helps keep the tumor under control without surgery.
Sometimes physiotherapy is the optimal solution for non-standard location of the lump
, in which excision can be a rather traumatic procedure.

This type of treatment helps relieve compression of nerve endings, eliminate pain and inflammation, improve tissue regeneration, and relax the muscles around the tumor.

In modern physiotherapy for hygroma of the wrist and other joints, the following is used:

• electrophoresis
  ;
• ultra high frequency therapy
  ;
• phonophoresis with hydrocortisone
  ;
• magnetotherapy
  ;
• paraffin applications
  ;
• mud baths and wraps
  ;
• UV therapy
  .

During the entire course of physiotherapy, and also, as prescribed by the doctor, after it, a tight, compressive bandage is applied to the area affected by hygroma, which prevents further accumulation of fluid in the capsule.

If the tumor is too large or continues to grow, there are signs of inflammation, the attending physician, together with the patient, usually decides on surgical intervention.

Drug treatment

For the medicinal treatment of hygroma, a wide range of anti-inflammatory drugs are used, which are applied to the surface of the cone or injected directly into its cavity.

However, anti-inflammatory therapy provides only a temporary and symptomatic effect

,
and therefore used in combination with other techniques
.

In case of a purulent process inside the cyst, and also as a preventive measure before surgery to remove it, the attending physician selects a specialized antibiotic for the patient - usually in the form of injections.

But the most effective medicine for the treatment of tendon ganglion are chondroprotectors

.

They are helping:

• establish metabolic processes in the tissues adjacent to the hygroma, strengthen muscles and ligaments, prevent the destruction of synovial cartilage;
• improve the quality of synovial fluid - as a result, the joint begins to produce it in smaller volumes, and the nutrition of the hygroma is reduced;
• slow down further growth of tumor formation;
• relieve symptoms of inflammation in the area of ​​hygroma;
• significantly reduce pain (many patients note a reduction in pain by 50-80%);
• cope with discomfort from the tendon ganglion, which cannot be operated on due to its small size.

Chondroprotectors do not allow the joint on which the hygroma occurred to “starve” due to poor supply of nutrients. They also relieve swelling and restore normal mobility in the fingers, hands and wrist joint. In addition, they have a systemic effect on the body, improving the condition of the musculoskeletal system and preventing the appearance of new hygromas, as well as the recurrence of old ones. Due to the almost complete absence of side effects, chondroprotectors can be taken to prevent synovial cysts even before they appear

,
during treatment of a neoplasm
, as well as
after surgery
.
Chondroprotectors stimulate tissue repair after surgery and prevent the re-formation of modified cells. The standard course lasts from 3 to 6 months per year. Compared to other drugs in this series, Artracam
, the course of which lasts 1.5 months, and then can be repeated after 2 months if necessary. It is made exclusively from natural ingredients - seafood.

Drug Artracam

is one of the most effective chondroprotectors for hygroma of the wrist and hand.

Operation

Indications for testing

Surgical intervention is performed either if the patient wishes (the hygroma causes him discomfort, physical or aesthetic) or if there are indications that directly recommend it:

• the neoplasm is painful, localized in such a way that it impairs mobility;
• the cyst interferes with a person’s professional activity;
• hygroma quickly grows or multiplies (there can be several synovial cysts on one finger at the same time);
• regardless of the measures taken, the tumor does not decrease;
• due to hygroma, neighboring tissues swell, are compressed, pain, numbness of the fingers or secondary aseptic inflammation occurs;
• an infection has penetrated the tissue, causing a purulent inflammatory process;
• the cyst has a risk of rupture due to location features, individual characteristics of the patient or the hygroma itself.

How is it carried out?

If there are such indications, the doctor is obliged to directly recommend surgical intervention. There is no need to be afraid of it: this is an easy operation that does not require opening the joint capsule. It is performed under local anesthesia, and the skin at the site of the cyst is excised, after which the tumor is carefully excised. Sutures are applied, and as part of the recovery, the patient must limit his mobility for some time.

Other methods

Sometimes another method is possible, which, in essence, is a puncture: a needle is inserted under the skin, which pierces the hygroma and pumps out all the liquid from it. The second needle burns out the shell at this time. When carrying out manipulation, the doctor must be careful: if you leave part of the cyst under the skin, it will not disappear, and an incomplete operation leads to an increased risk of complications. The laser method is also used, in which the cyst is burned out using a laser. It is even less invasive and is considered modern and progressive, but is often more expensive than other types of surgery.

Classification of hygroma

Depending on the location, number and type of fibrous capsules, the cyst can take the form of an anastomosis, valve or isolated formation:

• Anastomosis. Small cavities formed at the point of contact between the cyst and tendons and allowing fluid to move freely.
• Valve. A kind of organic barrier between the tumor and the articular membrane, preventing the penetration of synovial fluid into the cavity.
• Separate structure. Absolute isolation of the cystic formation.

The number of capsules can vary from one to several. In this connection, hygroma is distinguished as single-chamber and multi-chamber. Such a cyst is visualized as multiple nodular formations, concentrated in a crowded manner or located at a short distance from each other in independent formations.

Gouty tophi

Gout is a disease associated with impaired purine metabolism. Tophi in gout are deposits of uric acid salts in tissues.

• Men are more likely to suffer from gout, and the main reason for visiting an orthopedist is tophi;
• The location of the tophi varies greatly: from the toes to the auricles.
• their size varies - from a few millimeters to gigantic sizes;
• tophi tumors are dense and painless;
• with chronic injury from shoes, they can become inflamed, infected and suppurate;
• when the tophi are opened, a white mass (urate crystals) is released from them;
• 15-20% of patients with gout are carriers of urate stones.

Treatment tactics:

1. After conservative therapy and stabilization of uricemia levels, removal of tophi is indicated.
2. It is preferable to perform operations for small sizes of tophi tumors, without waiting for their growth or purulent fistulous complications.
3. The operations are local plastic in nature and are individual depending on the size and location of the tophi.

Taylor (tailor) deformation

Taylor deformity is characterized by varus deviation of the fifth toe and valgus deviation of the fifth metatarsal bone.

Characteristic signs of a “bump” on the foot:

• located at the base of the little finger;
• the fifth finger is deflected inwards, in some cases also upwards;

• The “bump” sharply increases in size and becomes painful when bursitis of the mucous bursa of the fifth metatarsophalangeal joint develops.