14. Tophi
Like Heberden and Bouchard nodes, tophi are growths or nodules that usually develop around the affected articulation or close to it. They are large bumps and are made of uric acid crystals. Tophi can form in the cartilage or bone and are not only found in one place. They can be on your feet, elbows, or hands. In some cases, they do not even form around an articulation. For example, they can be found on the outer edge of the ear. They are external, and you can see them as a lump in your skin. Tophi are not painful by themselves, but they can be infected and turn very painful. It is mainly an aesthetic problem but signals bone erosion and possible cartilage destruction as a part of gout.