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Magnetic resonance imaging diagnosis of gouty tophi in a man with gout and Bartter's syndrome

Systemic alkalosis, which is a prominent feature of Bartter’s syndrome, decreases the clearance of uric and may contribute to hyperuricaemia and gout. Tophaceous gout may sometimes present as a soft tissue mass, which is difficult to differentiate from an infectious or neoplastic process, and MRI has been helpful.2,3 We report a case of uncontrolled gout in a Polynesian man with Gitelman variant of Bartter’s syndrome and soft tissue masses in legs, which proved to be gouty tophi on MRI.