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Weak and Numb Feet in a Man With Knobby Hands
Arch Neurol. 2000;57:271.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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REPORT OF A CASE
A 91-year-old man with a 40-year history of progressively disfiguring tophaceous gout, hypothyroidism, and remote alcohol abuse presented to the hospital with a 4-month history of progressive weakness and numbness of the lower extremities (Figure 1 and Figure 2). Examination revealed a cheerful, elderly man with severe tophaceous gout affecting the proximal metacarpophalangeal and interphalangeal joints. He was clinically euthyroid.
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Figure 1. The patient's hands show bilateral, severe, disfiguring tophaceous deposits and joint deformities involving the metacarpophalangeal proximal and distal interphalangeal joints.
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Figure appears in full text version.
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Figure 2. Both feet show tophaceous gout deposits and joint deformities involving the great toes (halluces).
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Strength in the upper and lower limbs was 4 of 5 proximally, but it was 4+ of 5 distally. Sensory examination showed decreased pinprick, light touch, and vibratory sensations up to the knees bilaterally, but intact proprioception in the feet. The tendon reflexes were 1+ at the biceps, triceps, and . . . [Full Text of this Article] COMMENT
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