Periarticular and articular nodules represent as one of the most common manifestations of a wide variety of non-neoplastic and neoplastic lesions. These nodules tend to create diagnostic dilemmas, as most of them present with variable signs/ symptoms and have nonspecific laboratory findings. Amongst these, gouty tophus is an important differential, the diagnosis of which can be difficult in cases of unusual presentations, i.e., in the absence of arthritis and/ or hyperuricemia. The authors hereby present a clinically unsuspected case of gouty tophi in a 37-year-old male with a soft tissue swelling at 1st metatarsophalangeal joint of the left foot. Fine needle aspiration cytology played a pivotal role in clinching the diagnosis, thus highlighting its substantial role in diagnosis of periarticular nodules
