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Such findings reinforce that urate crystal deposition in tissues can be asymptomatic, but without appropriate management, the process can progress to destructive tophaceous disease ( Figure 1 - 10 ) over varying periods of several years to a decade or more

Sci Total Environ 777(10):146216

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Since I use a tiny tuberculin needle, most patients have no problem with the injection and dont need any extra lidocaine skin wheal or freezing spray