In the upper extremities, RA nodules are typically
found on the extensor surface of the forearm, and tophi
are usually located in the olecranon bursa of the el-
bow (Dore, 2008). They are frequently thought to be
late manifestations of poorly treated gout, but can be
found in soft tissues of patients with hyperuricaemia
prior to their first attack of gout (Perez-Ruiz, 2009).
Figure 1 shows a tophaceous gout affecting the
olecranon process.