A 74-year-old man with gouty arthropathy involving bilateral hands. PA radiograph of the right hand shows erosive and cyst-like changes about multiple joints of the hand and ulnar styloid with adjacent dense soft-tissue nodules (arrows) consistent with gouty arthropathy. Several erosions have overhanging edges, most notable at the radial aspect of the index finger proximal interphalangeal joint. Note faint calcifications within the nodular thickening adjacent to the ulnar styloid erosion.