Tophi are deposits of urate crystals
They can develop in longstanding gout, often around joints, fingers, toes, elbows or ears.
They are a sign of crystal burden
Tophi can affect movement, skin and joints. Their presence is one reason clinicians may consider a lower serum urate target.
They can improve with sustained urate lowering
Long-term treatment aims to reduce crystal burden over time. This is different from treating the pain of an acute flare.