Ulcerated tophaceous gout of the foot: a case report and retrospective chart review
Bibliographic record
Abstract
Ulcerated tophaceous gout is an uncommon presentation of the lower limbs. Treatment of these wounds can be a challenge, as their optimal management remains to be determined. Therefore, a retrospective analysis of medical charts between 2015 and 2021 was conducted at a wound clinic of a university-affiliated hospital to determine the characteristics of patients treated for tophaceous wounds, their evolution and treatment. We report a total of five patients with ulcerated tophaceous gout of the foot who initially presented predominantly with soft tissue infection or osteomyelitis. All progressed well with local wound care, including conservative sharp debridement of the tophi and rapid initiation of urate-lowering therapy. Therefore, a diagnosis of tophi should be considered in an ulceration of the first metatarsophalangeal joint or other toes when whitish-chalky material is present, even if the patient was not previously known to have gout. Tophi ulceration is a rare complication; however, prompt diagnosis and management are important to avoid destruction of the underlying bone structures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".