Findings:
There is focal soft tissue swelling at the medial margin of the MTP joint of the left great toe. There are also underlying corticated erosive changes in the flexor sesamoids. Corticated erosive changes are seen in the cuneonavicular joints, fourth, and fifth TMT joints, and the medial margin of the interphalangeal joint of the great toe, with little, If any associated cartilage space narrowing. There is no fracture, bony mass lesion, or other abnormality.

Impression:
Gouty arthropathy with a tophus medial to the MTP joint of the left great toe.

Recommendations:
For your training purposes, recommendations are not included in this report.