PMC9479508_01
(a) Clinical photograph showing an ulcerated nodule on the ankle. (b) Radiograph of the ankle anteroposterior view shows a lytic lesion in the ankle. (c and d) Photomicrograph shows negatively stained singly scattered and clusters of needle-shaped urate crystals in the background of blood; Giemsa stain x100, c; x400, d.
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F1
A 48-year-old male patient presented with a subcutaneous nodule and pain around the nodule on the posterior aspect of the left ankle for the past 2 years [Figure 1a]. Radiographs of the left feet (anterior-posterior view) showed a soft-tissue swelling overlying the posterior aspect of the ankle [Figure 1b]. Fine-needle aspiration demonstrated slender needle-shaped urate crystals seen in stacks and sheave and singly dispersed which are negatively stained in Giemsa stain [Figure 1c and d].
PMC9479508_02
(a) Clinical photograph shows a nodule in the shin. (b) Photomicrograph demonstrates slender needle-shaped urate crystals seen in stacks and sheave and singly dispersed needle-shaped urate crystals along with a few acute and chronic inflammatory cells and reactive giant cells; Giemsa stain x100 (c and d) photomicrograph shows singly scattered and clusters of needle-shaped urate crystals Giemsa stain x400, c; pap stain x400, d.
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F2
There was a firm immobile nodule measuring 1.5 x 1.5 cm [Figure 2a]. Microscopy showed many needles shaped crystals in aggregates and singly scattered, which are negatively stained in Giemsa and PAP stain, along with occasional multinucleated giant cells along with synovial cells and a few acute inflammatory infiltrates [Figure 2b-d].