Small tophi on the helix of the ear have a typical whitish appearance as a result of urate deposition. Small cartilaginous nodules are commonly present in the ears of normal individuals and can be mistaken for tophi. A tophus characteristically stands out as a discrete white nodule when pressed by the examiner's fingers. In contrast, the cartilaginous nodule will blanch out and blend with the rest of the ear. Transillumination reveals an opaque center in the tophus but not in the cartilaginous nodule.