[Severe tophaceous gouty arthritis can be treated but is still overlooked in healthcare].

This is a case report of a 68-year-old male with severe tophaceous gouty arthritis, diabetes, kidney impairment and ischaemic heart disease. The patient had repeated attacks of acute gout during a 20-year period and excessive tophaceous depositions. Walking was severely hampered by feet deformity and pain. No urate-lowering therapy was initiated despite contacts to several medical specialties. After the diagnosis was established, the patient was finally treated with allopurinol with an obvious beneficial effect on his symptoms and the size of the tophaceous depositions.