Use this tracker like a body map for a mole or other visible skin change: give each visible or palpable tophus an ID, mark its location, record a baseline measurement and photo, then compare the same area over time.
This tool is for documenting a known or suspected tophus for discussion with your clinician. It cannot diagnose a lump. If you are not sure a lump is a tophus, have it examined.
Step 1: Give each tophus an ID
Use simple labels such as T1, T2, T3. Keep the same ID every time you record that spot. If you have several close together, note the exact location in words as well.
Print this page and write T1, T2, T3, etc. next to each location. For ears, fingers, toes or other small areas, describe the exact side and location in the table below.
Step 2: Create a baseline
For each tophus, record what it is like today. A simple baseline makes later changes much easier to judge.
| Tophus ID | Exact location | Size (mm) | Photo label/date | Skin & symptoms | Effect on function |
|---|---|---|---|---|---|
| T1 | ___ x ___ mm | ||||
| T2 | ___ x ___ mm | ||||
| T3 | ___ x ___ mm | ||||
| T4 | ___ x ___ mm | ||||
| T5 | ___ x ___ mm |
Photo tips
- Photograph the same tophus from roughly the same angle and distance each time.
- Use similar lighting and background when practical.
- Place a small metric ruler beside the area so the photo includes a size reference.
- Do not squeeze, puncture or press hard on a tophus just to measure or photograph it.
- Keep the photo filename or phone album label tied to the same ID: for example, T2 – 2026-09-18.
Step 3: Record follow-up changes
Tophi usually change slowly, so the important question is not “Does it look different today?” but “Is there a consistent change over time?” A monthly check can be a practical home-recordkeeping interval unless your clinician recommends something different. New concerning symptoms should not wait for the next tracking date.
| Date | ID | Size (mm) | Smaller / Same / Larger | Pain or tenderness (0-10) | Skin change | Movement/function | Photo? | |
|---|---|---|---|---|---|---|---|---|
| ___ x ___ | ||||||||
| ___ x ___ | ||||||||
| ___ x ___ | ||||||||
| ___ x ___ | ||||||||
| ___ x ___ | ||||||||
| ___ x ___ |
Step 4: Add the urate and treatment context
A visible tophus is part of the body’s overall urate crystal burden, so a size record is more useful when it sits beside your serum urate and treatment history.
| Date | Serum urate | Urate-lowering medicine / dose | Recent dose change? | Notes for clinician |
|---|---|---|---|---|
| _____ mg/dL | ||||
| _____ mg/dL | ||||
| _____ mg/dL | ||||
| _____ mg/dL |
For a fuller urate record, use our Uric Acid Tracking Guide & Printable Log.
What changes should you write down?
- Clearly smaller or larger size.
- New tenderness or pain.
- Increasing stiffness or loss of motion.
- Skin becoming stretched, irritated, red or warm.
- White or chalky material becoming visible.
- Any opening, ulceration or drainage.
- Numbness, tingling, weakness or pressure symptoms nearby.
- A new lump in a different location.
Do not just track these changes – get medical advice
Contact a clinician promptly if a suspected tophus opens or drains, becomes increasingly red or hot, causes rapidly worsening pain, is associated with fever, produces new numbness or weakness, or significantly limits movement or function. An open or inflamed lump may need evaluation for infection or another diagnosis.
Bring the tracker to appointments
The goal is not to prove that a treatment is working from a photograph. It is to give you and your clinician a clearer longitudinal record: where the tophi are, whether visible deposits are changing, what your serum urate has been doing, and whether function or skin integrity is improving or worsening.
Print or save a copy: use your browser’s Print command and choose Save as PDF if you want a digital blank copy. Make extra copies of the follow-up table as needed.
This tracker is educational and is not a substitute for diagnosis or medical care. Do not change or stop prescribed gout medicines based only on home measurements or photographs.
Sources
- American College of Rheumatology: 2020 Guideline for the Management of Gout
- NICE NG219: Gout – diagnosis and management
- NIAMS: Gout diagnosis and treatment
- Cleveland Clinic: Gout Tophi
Tracker design also borrows the useful monitoring principles used in dermatology body mapping: fixed lesion IDs, body location, baseline photographs, measurements and change-over-time comparison. Evidence and tool design checked September 2026.