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Heiber, A

PMC 3045554

Common neurological manifestations include: Paraesthesia (pins and needles) in the hands and feet Numbness and altered sensation Difficulty with balance and coordination (ataxia) Memory problems and cognitive impairment Mood changes, including depression and irritability In severe cases, visual disturbances and confusion These neurological features arise from demyelination of peripheral nerves and the spinal cord, a condition known as subacute combined degeneration when it affects the posterior and lateral columns of the spinal cord

Figure 17: Large Tophus Seen as Soft Tissue Mass at the Elbow ) but in special cases, such as when gout needs to be separated from infection or tumor, magnetic resonance imaging (MRI) ( Figure 18: MRI of the Knee Showing Gouty Soft Tissue Mass and Erosion of the Kneecap ) or ultrasound ( Figure 19: Power Doppler Study Showing Gouty Inflammation at the Base of the 1st Toe ) will be helpful

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