Imaging Studies typical changes of gout Rad h aaiograpl in the first of erosions metatarsophalangeal with joint and fourth overhanging interphalangeal joint 悬垂的edes Erosions with maintenance of the joint space Erosions without periarticular osteopenia Erosions with overhanging edges Erosions with sclerotic borders. sometimes showing chronic tophaceous called cookie-cutter or punched-out borders 风石 gouty arthritis in the hands Erosions that are distributed asymmetrically among the joints, with strong predilection for distal joints, especially in the lower extremities 浙医二院17 浙医二院 Imaging Studies Gout. Radiograph of erosions with overhanging 悬垂的edges. typical changes of gout in the first metatarsophalangeal joint and fourth interphalangeal joint. showing chronic tophaceous痛 风石gouty arthritis in the hands. Erosions with maintenance of the joint space Erosions without periarticular osteopenia Erosions with overhanging edges Erosions with sclerotic borders, sometimes called cookie-cutter or punched-out borders Erosions that are distributed asymmetrically among the joints, with strong predilection for distal joints, especially in the lower extremities