Samit Hirawat, MD

A 73-year-old man was admitted to the hospital with pain in his hands, feet, and elbows. The patient, an alcoholic, had a 20-year history of hypertension and diabetes. Deformities of the hands and feet had developed during the past 5 years. Tophi were present over both ear lobes. The serum uric acid level was 15 mg/dL.

A 30-year-old man presented to the emergency department with new-onset seizures. His past medical history included loss of vision for 1 year, deafness, and osteomyelitis of the mandible.