Why Tophi Develop and How to Remove Them

Why Tophi Develop and How to Remove Them:

Tophi are small, round, flat stones found in your joints. They have been known to cause arthritis and pain if not removed.

There are many types of taphouses (trophies) but there are two main ones; the first type is called the ‘bunch’ or ‘cushion’. These rocks consist of several smaller rocks which when put together form a large rock with rounded edges. Some examples of these would be the size of a pea and weigh between one and three pounds. The second type is called the ‘ball’ or ‘cup’. These rocks consist of several larger rocks which when put together make up a large ball with sharp edges. Examples of these would be the size of a grapefruit and weigh over ten pounds.

The reason why they are so painful is because they contain tiny pieces of calcium carbonate (CaCO3). When calcium carbonate gets into your joints it causes inflammation and pain.

If left untreated, the damage can lead to cartilage destruction, bone loss and even arthritis.

There are two ways to remove them; either with a laser or using an injection technique. Laser removal involves heating the taphouse until all the calcium carbonate melts away leaving behind just stone fragments.

An example of this would be melting down a bunch of grapes before cutting them up into cubes. Injection involves placing a needle directly into the stone and injecting medicine to dissolve it. An example of this would be squeezing a bag of vinegar over a bowl of cubed grapes.

The laser procedure tends to work better on stones that are lower than five pounds, however we have had both success and failures with both types of removal techniques.

Sources & references used in this article:

Tophi–surgical treatment by I Słowińska, R Słowiński, L Rutkowska-Sak – Reumatologia, 2016 – ncbi.nlm.nih.gov

Tophus causing bronchial obstruction by R Adamson, JM Lacy, AM Cheng… – American journal of …, 2013 – atsjournals.org

Gouty tophus without gout attacks treated using a reversed digital artery flap by Y Okuhara, K Shimbo, S Nagamatsu… – Case Reports in Plastic …, 2020 – Taylor & Francis

Diagnosis and treatment of gouty arthritis by JH Talbott – Postgraduate Medicine, 1949 – Taylor & Francis

Treatment of tophaceous gout: when medication is not enough by IR Kasper, MD Juriga, JM Giurini… – Seminars in Arthritis and …, 2016 – Elsevier

Investigation and management of gout in the young and the elderly. by PA Dieppe – Annals of the rheumatic diseases, 1991 – ncbi.nlm.nih.gov

Auricular Multiple Tophi Presenting as Painful Bilateral Nodules: A Case Report and Literature Review by JH Choi – Journal of Clinical Otolaryngology, Head and Neck …, 2020 – researchgate.net