Viewer discretion advised
This video shows a real surgical procedure performed by Dr. Panchal. It is medical in nature and may be graphic.
Real procedure performed by Nikul Panchal, DPM, FACFAS. Footage is silent and shared with consent for patient education. Viewer discretion advised.
Viewer discretion advised
This clinical photo shows advanced disease and open skin. It is shared for education and may be graphic.
At presentation — years of untreated tophaceous gout.
About this procedure
Gout is crystallized uric acid in and around the joints. Left untreated for years, those crystals collect into chalky deposits called tophi — and in extreme cases they erode through the skin. This is the most severe case of gout Dr. Panchal has seen in his career; most providers never encounter tophaceous disease this advanced.
In this clip — sped up for viewing — Dr. Panchal expresses the gouty tophi in the operating room. It is strangely satisfying to watch, and it shows exactly why gout should never be ignored until it reaches this stage.
The video is silent, sped up, and shared with patient consent. If you have recurring gout attacks, modern management can prevent this outcome entirely.