Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 4 3 2019 11 04 69 72 Anahita Sadeghi Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Mona Talaschian Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Sudabeh Alatab Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran. 2019 07 29 2019 07 29 Gout is a type of inflammatory arthritis that results from the deposition of monosodium urate crystals in the articular or periarticular tissues. In this educational case, we report a middle- aged man who presented with multiple nodules distributed bilaterally over the dorsum of his hands, feet, and elbow joints. Based on clinical and histological findings, the nodules were found to be gouty tophi, and the patient was diagnosed with tophaceous gout characterized by collections of solid urates in connective tissues. https://crcp.tums.ac.ir/index.php/crcp/article/view/288 https://crcp.tums.ac.ir/index.php/crcp/article/download/288/319