In a patient with gouty ahritis, strongly birefringent needle-shaped crystals with negative elongation in synl fuid aspiration are composed of: September 2007

Ans. A: Monosodium Urate Gout is a metabolic disease most often affecting middle-aged to elderly men and postmenopausal women. It is the result of an increased body pool of urate with hyperuricemia. It is typically characterized by episodic acute and chronic ahritis, due to deposition of Monosodium urate (MSU) crystals in joints and connective tissue tophi, and the risk for deposition in kidney interstitium or uric acid nephrolithiasis. If the clinical appearance strongly suggests gout, the diagnosis should be confirmed by needle aspiration of acutely or chronically involved joints or tophaceous deposits. Acute septic ahritis, several of the other crystalline-associated ahropathies, palindromic rheumatism, and psoriatic ahritis may present with similar clinical features. During acute gouty attacks, strongly birefringent needle-shaped MSU crystals with negative elongation are typically seen both intracellularly and extracellularly. Synol fluid cell counts are elevated from 2000 to 60,000/