A 51-year-old man presented with persistent pain localised to the right clavicle after consuming 1600 mL of beer. The patient has a medical history of gout but no history of trauma or infection at the lesion site. Physical examination showed that the patient’s temperature was of 37.4°C, presenting only pain in the right sternoclavicular joint and no symptoms of pain in any other joint. Laboratory examination showed normal serum uric acid levels (412 µmol/L; normal range: <420 µmol/L) and elevated erythrocyte sedimentation rate (ESR) (19 mm/hour; normal range: <15 mm/hour). One year prior, the patient underwent surgical intervention to remove tophus from both elbow and ankle joints. After the operation, the patient adhered to a regimen of febuxostat regularly.

Long-axis grey-scale ultrasound showed a …