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About Gout Gout is a common disease caused by the deposition of monosodium urate (MSU) crystals in patients with hyperuricemia, and characterized by very painful recurrent acute attacks of arthritis.
Monosodium urate crystals were detected in synovial fluid aspiration, and the patient was diagnosed with gout.
Gout is a common disease caused by deposits of monosodium urate crystals accumulating in joints and surrounding tissues.
About half of cases involve the big toe, but it can present as gouty tophi (a deposit of monosodium urate crystals in the joints, cartilage, bone, and throughout the body that may break out through the skin), kidney stones, or urate nephropathy.
The disease is asymptomatic; the patient has persistent hyperuricaemia, and synovial fluid analysis shows monosodium urate (MSU) crystals.
Clinically significant crystals include calcium pyrophosphate crystals that are seen in pseudogout and monosodium urate crystals that are seen in gout.
CT-guided aspiration recovered small amounts of fluid positive for monosodium urate crystals, and with negative Gram staining and culture growth.
Cytologic examination of the white to yellow chalky aspirate material showed monosodium urate crystals (arrow, Fig 3), which were birefringent under polarized light (arrow, Fig 4).