Question
Most specific diagnostic finding in gout is
The correct answer is
Presence of monosodium crystals in synovial fluid
Gout Diagnosis: Identifying the Most Specific Finding
Diagnosing gout accurately requires identifying findings that are unique to the condition. While several tests can indicate potential issues related to gout, one finding is considered the definitive diagnostic marker.
Analyzing Diagnostic Options for Gout
- Raised serum uric acid: This condition, known as hyperuricemia, often accompanies gout but is not specific. Many individuals have high uric acid levels without gout, and some gout patients may have normal levels during an attack. It's a risk factor, not a conclusive diagnostic sign.
- Uric acid crystals in urine: While possible, these crystals are not exclusively found in gout patients and can appear in other kidney-related conditions or states of dehydration. Therefore, they lack diagnostic specificity for gout itself.
- Calcium pyrophosphate crystals in synovial fluid: The presence of these crystals is the hallmark of pseudogout (calcium pyrophosphate deposition disease), a different condition from gout.
- Monosodium urate (MSU) crystals in synovial fluid: The definitive diagnosis of gout is confirmed by identifying needle-shaped, negatively birefringent monosodium urate crystals within the synovial fluid obtained from an affected joint. This is the gold standard and the most specific diagnostic finding for gout.
Conclusion on Specificity
The presence of monosodium urate crystals in synovial fluid is the most specific indicator for diagnosing gout, distinguishing it clearly from other conditions.
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Important Questions from Arthritis
- Which of the following statements regarding Ankylosing spondylitis (AS) are true?
1. AS occurs in about 10 % of Inflammatory Bowel Disease(IBD) patients
2. The AS activity is related to Bowel activity in IBD patients
3. The AS activity does remit with glucocorticoids or colectomy in IBD patients
Select the correct answer using the code given below: - Which of the following statements about “Early onset Osteoarthritis” are true?
1. Onset is usually before the age of 55 years
2. There is clear history of previous trauma
3. In most cases, single joint is affected
Select the correct answer using the code given below: - A 31-year young man presents with fever, weight loss, pain with swelling of knee joint and low backache with stiffness. Three weeks earlier, he was treated for symptoms of urinary tract infection by local practitioner. The joint aspirate is leucocyte rich and contains multinucleated macrophages. His urine culture is sterile. What is the most probable diagnosis?
- Consider the following statements regarding Gout in old age.
1. Most of older patients have gout secondary to diuretic use and chronic kidney disease
2. Joints of the upper limbs are more frequently affected
3. Presentation is typical with acute attack of gout
Which of the statements given above are correct? - A 28-year old woman complains of arthritis involving bilateral metacarpophalangeal, proximal interphalangeal and wrist joints of one year duration. The most likely disease entity is:
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