systems and methods for assessment of the reduction of tophus burden with effective urate - lowering therapy were developed . the first application of computer - assisted methods for accessing tophus response included standardized digital photography , computer assisted measurement and analysis of tophi by an independent reader and blinded central reader paradigm . the ability of the method for computer - assisted analysis of digital photographs to quantify reduction in tophus size demonstrates its feasibility as a urate - lowering therapy monitoring tool in the treatment of tophaceous gout .